June 2007
"The 21st century healthcare system is using a 19th century paperwork system." -- President George Bush
While hospitals are leading the medical technology charge into a new century, President Bush is correct in his assessment that healthcare paperwork has not changed much since horse and buggy days. Massive paper files occupy huge amounts of storage space in many hospitals and are not suited to a mobile society and our complex healthcare system.
Hospitals are moving to replace paper files with the Electronic Medical Record, or EMR. A national goal has been set for most Americans to have electronic medical records by the year 2015.
At Union Hospital, Carey Gardner, director of community relations, says that national goal will be achieved much sooner at the hospital in Dover.
?We started the transition to electronic medical records several years ago,? Gardner said. ?It?s a process that will take five years to complete.?
Nurses chart their patient information
using a WOW - a wireless on wheels computer.
Converting Union Hospital from paper to
electronic charting was a huge project
spearheaded by Lorna Espinas (left) of Dover,
manager of applications and Michele Garber, RN,
(right) of Dover, director of nursing services.
A typical medical record includes a detailed history of care provided to a patient such as physician orders, test reports, x-rays and other medical images, transcriptions, medication records and nearly everything else connected with the patient?s care.
The content of a person?s medical record grows over time. Gardner says the electronic record does away with the massive volume of paper and takes advantage of the versatility of computers to store this vast amount of data.
?Our transition to an electronic medical record is being done in four phases that started in June of 2005 and will be completed in 2009,? Gardner said. ?It?s an aggressive schedule and one that is a challenge to our staff to implement.?
One of the changes patients and their families will notice is the transition away from the paper chart. For generations a clipboard hung at the end of the bed or was housed in a wall cabinet outside the patient?s room. Gardner says nurses, therapists, and other patient care professionals do their charting at mobile computer workstations the staff has dubbed ?WOW?, meaning Wireless On Wheels. The WOW can move from room to room and is tied in to the hospital?s computer system through a wireless network.
As the electronic medical record grows, Gardner says this vast amount of patient information is stored electronically with multiple layers of redundancy and safety backups.
?The issues of security and confidentiality are at the forefront. Patient information is protected by systems and technology that cannot be disclosed to help ensure their integrity.?
On the surface, the arrival of the EMR will not change how doctors, nurses, and others treat the patient. Other than seeing even more computers at nursing stations and WOWs rolling through the hallways, Gardner says nurses, doctors, and other healthcare professionals will still provide personal care at the bedside.
?Patients will continue to wear a wristband and be asked for their name or birth date each time care is provided,? Gardner said. ?Hands on personal care is expected by every patient and technology will not get in the way of that bedside relationship every caregiver has with their patient.?
Gardner points to significant benefits from this investment in technology including reduced risk of medical error, less paperwork, and improved cost control.
But the cost of those improvements is steep. Over six years Union Hospital will invest $10.7 million in the technology and people to fully implement the electronic medical record. Union Hospital selected the software system from Medical Information Technology, Inc. (Meditech) as the platform upon which to build. Meditech is the largest hospital information system company in the world and is currently in use in over 2100 hospitals around the world.
Gardner says the hospital and its off-campus sites have an incredible array of computer technology needed to maintain the flow of information including 905 desktop and laptop computers, 350 printers, 100 wireless charting carts, 88 servers, and 61 tablet PCs.
?Of critical importance to this entire process is the skill and expertise acquired by the hospital?s Information Technology Department,? Gardner said. ?Their knowledge of the software applications and ability to support the more than 1,000 users on the hospital?s network helps ensure this technology delivers all the patient care benefits we expect.?
