As the federal and state governments continue to move forward with “paperless” initiatives, so goes the health care system, which is endeavoring to create better outcomes and fewer medication mistakes by forgoing ink and paper.
Taconic Health Information Network Community (THINC) based in Fishkill was founded in 2007 with a $5 million New York state Health Efficiency and Affordability Law (HEAL) grant and tasked with helping hospitals, health care centers and private practices make the switch from written to electronic medical records.
Susan Stuard, executive director of THINC, has two ambulatory electronic health records initiatives (EHRs) now being used by a federally qualified health center. “We are working with four of them at present, and will have 500 physicians with EHR capability before the end of the year.” THINC”™s territory covers Westchester, Orange, Dutchess, Putnam, Rockland, Sullivan and Ulster, where 31 hospitals and eight federally qualified health centers serve its territory. Those participating remain unnamed for now.
As of June, another five EHR systems are in place serving 10 hospitals, said Stuard. Two models are being utilized in the EHR system, a push and a pull:
“Model 1 is what we consider a ”˜pull,”™” said Stuard. “If I have John Doe as a patient and get his consent to make a query, I can see if there is any information on the health exchange. That model is the one you will see more of on a regional basis. If a patient is having a procedure at Westchester Medical Center and goes for follow up care at Kingston Hospital, we have the ability to go to a link in the EHR and look for the records. That”™s the model we are involving the hospitals and doctors in.”
Stuard said Model l is “particularly powerful when it comes to treatment in the emergency room; it can provide vital information that can save a life. If someone has an allergy to a medication, or has had a procedure the staff should know about, that critical information can be obtained.”
If the patient is unconscious and unable to give consent, the attending physician can access EHRs with no repercussions for the physician. “It”™s a judgment call,” said Stuard, “and often, a call that helps the doctor correctly treat the patient.”
Stuard said the second model is slightly different but more direct. “We call this the ”˜push,”™ where you get information from the patient. If someone sees their primary care physician and is recommended to a cardiologist, a consent form will be sent back to the primary health care physician. If the patient is admitted for a cardio procedure, those records can be retrieved by the primary care physician. It”™s proactively pushing the information.
“It directly supports the health of the patient,” she said. “The primary care physician knows the change in medication and/or treatment and can act accordingly and adjust the medication so the patient is not prescribed something that will affect them adversely.”
Both models, said Stuard, are equally important.
It is not necessary to track the health of a person from the moment of birth until the date of death said Stuard. “EHR focuses on the current health of the patient. It gives us a good snapshot as to where the patient is. The goal is a little more concise. It also gives the patient control. Do patients really want every piece of their health care information available? There are privacy issues to consider.”
Where it makes sense, records can be put on a USB drive for the consumer. Said Stuard, “Some places are offering this to their patients. The EPIC program has a personal health record that”™s called ”˜My Chart,”™ where the patient can be given a user ID and password to see information recorded during their hospital stay.”
THINC works with the New York e-Health Collaborative and the state Commissioner of Health Office to improve standards for public health reporting. “That is very important for all of us,” said Stuard, “but slow going.”
In the HITECH Act of 2009, the federal government authorized $20 billion to promote the adoption of EHR records. In New York, 46 percent of primary health care providers and 38 percent of hospitals are using EHR.
In 2010, THINC joined Taconic Independence Practice Association (TIPA), with nearly 4,000 physician members focused on initiatives to transform medical practices and improve health care quality, and MedAllies, a health information services provider that facilitates physician practice redesign to launch the Hudson Valley initiative.
The Hudson Valley Initiative is a shared effort in which the three entities”™ goal is to improve the quality, safety and efficiency of health care and, according to its June 2011 press release, “to create a sustainable financial model for health care that lowers costs and increases quality; and health information technology used as a tool to improve patient health care and community health.”
Orange Regional Medical Center”™s new hospital, scheduled to open on or about Aug. 5, has implemented the EPIC EHR system. The hospital recently celebrated the conclusion of a 10-week training process so its staff of 2,500 can master the new software. Its $36 million price tag was the highest single expenditure for the hospital this year, but one ORMC board chairman Lou Heimbach said was critical for patient care and better outcomes.
EPIC has the ability to “talk” to other software EHR systems, according to Dr. Shafiq Rab, ORMC”™s chief information officer. “There is a software program that also allows hospitals and health care providers on different systems to link to each other. Eventually, a physician will be able to get a patient”™s health history, the medications they are taking, allergy information and everything necessary for them to receive a better outcome, with much less room for error. It is the future of health care.”
Should a patient still make sure they have a copy of their own medical records and keep them up to date? For now, sources said, it would be the prudent course to take.
