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Medical documents filed electronically for ease of use, quick access

By Staff | Sep 19, 2009

Electronic medical record systems where patient information is shared among hospitals, private practices and patients are no longer science fiction.
Physician offices across Lee County have already installed EMR software to increase accuracy, eliminate redundancy and offer better health options for patients.
Family Health Centers of Southwest Florida launched its software at the end of 2005, said Bob Johns, senior vice president of development and special projects, who added that he couldn’t remember the days when records weren’t electronic.
“We love it,” said Johns. “We are getting ready to upgrade to our second and third edition of Sage Medical Manager.”
There are various systems on the market, such as Sage Medical, Allscripts, Centricity and Patient Now, for example.
The EMR system at Family Health Centers, used in 14 offices and featuring a patient catalogue of more than 60,000 patients, will soon upgrade to let patients track their own hemoglobin or blood pressure from home.
According to a March 2009 survey by the Independent Physicians Association of Lee County, 263 or 22 percent of 1,200 physicians in the community are storing their records electronically. The average number of hospitals using EMR in the United States is 17 percent.
Officials at Lee Memorial Health System have spent the last three years lobbying for the entire system to go electronic by 2011. Chief Information Officer Mike Smith said practicing medicine boils down to doctors moving information around to determine a diagnosis and treatment.
“This is all about making it that when you come into a physician it isn’t a guessing game,” he said. “There is a lot of opportunity to save money and improve care delivery.”
Any time a patient visits a hospital or physician office, doctors will have instant access to that patient’s medical history, family history and what medications they are taking. With this type of detailed access doctors can avoid ordering unnecessary tests to determine a patient’s ills, and this saves money.
Knowing a patient’s history, as well as old and current treatments, can also prevent bad reactions from any new medications, therefore improving the quality of care. Furthermore, EMR systems allow patients to access their records from home and be involved in their own care.
If, for example, they are diabetic, the patient can upload their insulin levels for the doctor to see on a daily basis.
The push to adopt EMR software is by the federal government, which offers incentives under the American Recovery and Reinvestment Act, but also by doctors and administrators who view the current healthcare system as unsustainable.
“Healthcare in its current form isn’t affordable,” said Smith, who stressed that that Medicare is likely to go bankrupt by 2016. “Medicine in its current form is no longer sustainable.”
The Lee Memorial Health System utilizes EMR systems today. They have chosen a software program named EPIC that has already been installed at Lee Physician Group offices and the emergency departments at Cape Coral Hospital, Lee Memorial Hospital and Health Park Medical Center. Each of the hospitals will also launch EPIC, starting with Gulf Coast Hospital in 2011.
In the stimulus bill, hospitals are eligible to receive $19 billion to go digital. Lee Memorial Health System will receive between $30 to $40 million in aid if they start meaningfully using a certified EMR system by 2011, an amount that offsets some of the $70 million total installation of EPIC.
Not only is the government enticing hospitals to adopt this technology with stimulus funds, but those who don’t adopt EMR software will eventually see their federal funding decrease.
Incentives from the federal government are delivered through Medicare and Medicaid payments, and according to new regulations, if hospitals aren’t using EMR systems by 2016, they will see a reduction in those reimbursements.
Once launched in Lee County, the system will include the medical records of one million residents who have visited a Lee Memorial Health System office at least once in their lifetime.
Hospital officials are confident that the system will improve health care in Lee County.
“An effective, well-designed and appropriately utilized EMR can truly improve health care safety, quality and efficiency on behalf of the patients and families we serve,” said Lee Memorial Health System President Jim Nathan, in a prepared statement.
Some in the community are concerned about the security of their medical records, especially in the digital age when private information can be hacked and sold to the highest bidder. Smith said officials are tackling safety precautions with EMR systems, but having stringent security measures is counterproductive to having open access to information.
“Security is a conflicting goal for open records,” said Smith. “We have to make sure we use reasonable and prudent security.”
Smith added that lap tops and computers with sensitive information are encrypted in case of theft, and the EMR system will automatically track who is logged on and who is accessing what record.
“Paper records aren’t risk free either, but it is a serious concern we are aware of,” he said.
Although some private practices view a patient’s medical record as belonging to their office, Smith said Lee Memorial Health System’s philosophy is that a patient’s record belongs to them and that the hospital is simply a custodian of that record. They are also hoping to reach out to the community once the system is up and running.
“The health system also intends to ‘link up’ with interested community physicians who are not employed by LMHS,” said Nathan.
The system wants to connect with other medical offices and create a large county-wide database of patient information.
Smith and other officials have already begun talks with local practices on integrating systems, but some may not like the idea of sharing their records and others may have a hard time linking their current software with EPIC.
“We are still early in the conversation,” said Smith. “There will be a natural aversion to it, some will want to and there will be others that may not.”
Johns, from Family Health Centers of Southwest Florida, said that EPIC is designed more for a hospital system, and as a result any interfacing of the systems would be difficult. He added that the center is open to communication.
“The two systems can communicate, it takes a little effort, but you can do it,” he said. “We like our system and we are committed to it.”