Medical records migrate to microchips - Westfair Communications

To help hospitals and physicians”™ groups pay for the expensive and complex process of expanding their electronic records, U.S. Rep. Maurice Hinchey, D-Hurley, has secured approval for a $100,000 grant for the Institute for Family Health in New Paltz and $175,000 for Kingston”™s Benedictine Hospital.

The House-approved funds still need a U.S. Senate OK.

The Institute for Family Health, a nonprofit primary-care system that was recently formed through the merger of the Mid-Hudson Institute and the Urban Institute of New York City, will use the money to help pay for the $800,000 implementation of an electronic medical records (EMR) system. The merger was partly driven by the expediency of having the New Paltz facility sign on to the Urban Institute”™s in-place EMR system, said Dr. David N. Mesches, chairman of the board of the Mid-Hudson Institute.

“This gives us access to EMRs,” said Mesches. “Before, it was too expensive. The New York-based arm already has EMRs, so in essence we”™ll be extending an already-existing system.” The implementation is under way at the institute”™s Hyde Park office, with the EMR system scheduled to go live in September. The offices in Kingston, Ellenville, Port Ewen and New Paltz will follow.

Mesches ticked off the benefits of an EMR system: easy readability and retrieval of patients”™ records, which have a maddening tendency to get lost in a paper format; automatic reminders for follow-up care; data on patients, such as allergies and blood sugar levels, at nurses”™ and doctors”™ fingertips; screen alerts of pharmacy issues; better tracking of prescriptions; and easier auditing of federal reimbursements for Medicaid and Medicare. “It”™s a system that really improves efficiency and accuracy,” he said.

The EMR system in use in city locations and being deployed upstate is Epic, which is a state-of-the-art program with privacy controls already built in. It”™s used by the Mayo Clinic and other prestigious medical institutions, Mesches said. The system is also utilized at Beth Israel Medical Center, in Manhattan, allowing for a seamless exchange of information with the Mid-Hudson Institute. By implementing a system that is already up and running, the institute”™s upstate locations will benefit greatly from the Urban Institute”™s expertise in terms of training. “There”™s already a staff in New York that”™s fully able to utilize it. It”™ll be much easier to have these people come and train the staff” rather than start from scratch.

Reimbursement angle

Another benefit of the merger, Mesches added, is that it enables the Mid-Hudson Institute to attain the Urban Institute”™s federal qualification for Medicaid and Medicare, which will result in better reimbursement rates. Formerly, the Mid-Hudson Institute was state qualified.

Benedictine has had an EMR system in place for a decade. Though management hasn”™t yet earmarked the grant money, John Finch, the hospital”™s vice president of corporate development, said it is looking at automating more systems in the emergency room. Plus, “constant hardware upgrades need to be done. We have a wireless network in the entire hospital that we want to utilize more. We”™d like to allow nurses to have palm devices to take vital signs in charting.”

Currently, nurses use laptops to enter information onto patients”™ charts; tests and reports are ordered electronically. The hospital also has a PAC (picture archive communications) system that enables X-rays and other images to be read and transmitted electronically. Finch said physicians don”™t currently have the ability to input notes electronically while they are examining patients ”“ the information is dictated and then input into the EMR manually ”“ which is another function ripe for investment.

The process of upgrading is continuous, Finch said. “We”™re constantly adding things, such as central scheduling systems, which will soon allow doctors”™ offices to schedule a CAT scan by searching availability at the hospital and plugging in a time through the Web, rather than picking up the phone.”

Benedictine”™s planned merger with Kingston Hospital, currently under way, as required under the state”™s Berger Commission, is complicating things. The Berger Commission specified a number of closings, downsizings and mergers ”“ including the alignment of the two Kingston hospitals ”“ and set a year-end deadline for the changes to be implemented.

Both hospitals utilize the QuadraMed software for their core systems, providing an interface capability that will enable them to work together. “We”™re both pretty much up to speed, although we”™ll have to give and take on some systems,” Finch said.

”˜THINC”™ of it

Meanwhile, the Taconic Health Information Network and Community Regional Health Information Organization, (THINC), based in Fishkill, has received the first check for the $5 million grant it received from the New York State Department of Health (DOH). The grant was awarded by the DOH as part of the HEALNY program, which provides funding for health-care technology initiatives.

The goal of the nonprofit THINC is to create an electronic, standardized information network for physicians in eight counties. Five hospitals in Dutchess and Ulster counties are involved.

The grant money is being used to purchase 1,000 licenses for certified EMR software for physicians. The licenses alone cost $8,000 to $9,000, according to Lamott Dupont, acting executive director at THINC. They are being awarded to physicians on a first-come, first-served basis. Participants in the exchange will also get training and implementation support from THINC.

Historically, the hospitals and physicians have relied on Internet-based portals, which allow clinicians to access information about patients online, including lab results. The EMRs, which are replacing that system, have the advantage of more robust functionality, including tracking administrative activities. Plus, the records will be owned by the physicians. The portals are owned by the hospitals.

Given the reliance on the portals, the transition to the new EMR systems is a bit tricky: “We”™re straddling one boat and putting our foot in another,” said Dupont. “The trick is to make sure as functionality progresses, we don”™t lose something of value to the stakeholders. The ultimate vision is to have that robust exchange between all entities. We”™re moving there in increments.” One challenge with the hospital portals, he noted, is that each is different, requiring the physician to learn multiple interfaces.