The state Health Department has given a $1.2 million grant to a group that is assisting health organizations in developing the infrastructure to share electronic medical records.
The money will be used to subsidize implementation of EMR systems by doctors, said Robert Diamond, chairman of the Greater Hudson Valley Regional Health Information Organization and also vice president and chief information officer at Orange Regional Medical Center.
So far more than 100 doctors are involved ”” representing more than 100,000 covered patients ”” with money available on a first come, first served basis. The EMR software costs $600 per month but the grant money is paying for half the cost. The grant was awarded under the HEALNY program, which funds health-care technology initiatives in the state.
“When a doctor gives a patient an order to the EMR or a lab test, we can push it to the doctor”™s office,” Diamond said. “The doctor can view charts from the hospital” using the software.
He noted that getting data from a specialist, a hospital and physician to match “is very difficult. Nothing links up.” Diamond said one goal of the health-information group is to create a portal where everyone can share the same information. This would be more easily achievable “if it were mandated, as it is in countries like the U.K., where you have one system being used by every hospital. Here there”™s no requirement hospitals have to do this. ” More federal and state dollars to help the process along would also be a big boost, he said.
Diamond said Orange Regional is an early adapter for EMRs, with all departments, including the lab, radiology, radiation and oncology, utilizing the electronic format. Imaging, from mammograms to ultrasounds, is now done digitally and can be viewed remotely by a doctor. At Orange”™s two campuses ”” Horton and Arden Hill ”” nurses in the emergency department are now charting electronically using wireless computers on wheels.
Within the next few months, Orange Regional will be implementing the technology for documentation by physicians, enabling a doctor to chart a patient or order services directly through the computer. The hospital is using Cerner software and has been integrating and building new applications into the system since implementation in 2003.
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The systems ensure that medication is being prescribed correctly. Through protocols built into the manual process, the system can automatically fire off an instruction to the wounds department, for example, if a nurse indicates a patient has a high chance of getting a bed sore.
The total investment for Orange Regional, which has 450 beds on its two campuses and 12 off-site locations, has been more than $14 million, Diamond said. “It”™s a process that takes years,” he said. “You have to upgrade every year.”
Savings are realized in small and large ways. The considerable cost of producing film, for example, has been eliminated with the electronic imaging technology.
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Diamond said that because Orange Regional had a healthy balance sheet, it was able to afford the up-front cost ”“”“ not a given for many hospitals in New York state, given the tight profit margins of 1 percent to 2 percent. “The organization needs to make a commitment and find the resources” in order to remain competitive, he said. In New York, making the investment “has always put hospitals in a predicament since we are underreimbursed, especially under the HMOs, for Medicare and Medicaid” and have higher than normal costs.
Diamond said because of these special concerns, “vendors have realized they have to price their product a little bit differently” in the state. “I”™m a nightmare,” he said. “They”™ll be looking for volume, and I”™ll string them along until we get to the right place. In another other state, it”™s a much more competitive environment for vendors. But they want to be in New York because of all the hospitals that are here.”
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