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Exempla Lutheran Logs on to Medical Records

January 14, 2010
Exempla Lutheran logs on to electronic medical records by: Article Contributed on: 11/13/2009 10:28:28 AM Exempla Lutheran Medical Center joined its partner hospitals Nov. 1 when it went live with a secure electronic medical record system. For patients, it means their records will be continuously updated. Medications, treatment notes, allergies, lab tests and billing information will be entered into the secure system and accessible only to authorized personnel. When a patient is treated at the hospital their doctor will be able to view their medical record and when and if they return, patients won't have to remember the last time they had a test because results will be in the EMR. From a command center at the hospital last week, technicians, nurses and doctors were in training mode. Trained users in green vests roamed throughout to answer questions from the staff. Exempla CEO Bob Malte said the system for all three hospitals (St. Joseph, Good Samaritan and Lutheran) cost $85 million. An additional $4 million would be invested in a Physician Network Clinic, to include physicians that are part of the Exempla community. He said remuneration from federal stimulus funds was possible, but the amount was not clear. "It's a big investment, but unlike normal businesses that invest to get a financial return, the return here is patient safety and better clinical outcomes and the ability of our staff to spend more time with their patients," Malte said. Malte said besides the safety factors, it would help reduce errors, particularly in transcription of pharmaceutical information. The system includes prompts to users so details are not overlooked. David Pecoraro, chief information officer, said by having all hospitals integrated, the ability to make quick decisions was enhanced. Command center director Michelle Sullivan said the entire staff is trained on the system - therapists, secretarys, dieticians, technicians and of course, nurses and physicians. Login security is tight and patient information can only be viewed by authorized personnel. Nurses received extra hours to allow for training and tip sheets are distributed as new updates become available. Workstations are mobile. When nurses interview patients the monitors are turned so the patient can review the information as it is entered. Malte said a few years ago the hospital measured what percentage of a typical nurse's day was spent with the patient and it was 35 percent. "Now it's 45 to 50 percent and our goal is to get to 70 percent. That's where the value occurs when a nurse can spend more time with a patient. The computerized system reduces the amount of time they have to spend looking for paper records, because it's right there," Malte said. He said patient response had been positive. One of the challenges has been for employees to change their work habits. "We're asking proven professionals to change their ways. Accommodating the change process is the most challenging aspect," said Pecoraro. Malte said another challenge, as the medical field moves toward computerizing records, is the economic challenge it presents to physicians who can't make the kind of financial investment. "Even though we just installed this, we will turn on another feature in 2010 called Computerized Physician Order Entry, so doctors can input their orders directly," Malte said. He said it would further eliminate errors in transcription. Another challenge he said was a tendency to over rely on computers. He said, "One has to be careful to use it as a tool and support, but not a replacement for judgment and situational awareness." Although the system is not yet refined to be integrated with other area hospital systems, such as the Centura Health, Exempla is integrated with Children's Hospital. Centura Health Senior VP and Chief Information Officer, Dana Moore said Centura also is proud to be an early adopter of the electronic medical record (EMR). "EMRs ultimately improve quality, safety, efficiency and allow for thorough integration of patient information. It has allowed Centura Health to transform health care delivery to its patients and residents by enabling multiple caregivers to interact using state-of-the-art technology, improving communication, facilitating best practices, providing instantaneous patient care updates and improving the overall quality of care,"said Moore. Dick Barkey, program administrator for nonprofit single payer system advocate Healthcare for all Colorado, said more effort was needed to make the integration technology standardized and designed in the public domain.