Taking a cue from the popular “Star Trek” theme, the hospital has ventured into uncharted territory with its “E-Health Odyssey” — a $13 million effort that will see by the end of this year the hospital doing much of its medical charting electronically — doing away with the centuries old practice of using paper.
Developing an electronic medical records system has been a goal of hospitals for more than two decades. Many have ventured that way, few have succeeded. Sierra View officials feel the time is right and there is no “fail” in their vocabulary.
“This is the beginning of a new era,” said Dr. Fred Young, an orthopedic surgeon who is closing his private practice to assist the hospital in its quest.
Once the first phase of the project is completed in November of this year, much of what is done at the hospital — from the temperature of a patient to the medications they receive — will be charted electronically. No longer will there be thick files.
The hospital has designated a team to lead its quest — led by CEO Dennis Coleman and Dr. Young. Other key components of the team are hospital Chief Financial Officer Doug Dickson, Dan Sulger, head of clinical services; Kevin Shimamoto, project director and Kathleen Widlund, vice president of care services.
President George W. Bush first set a goal of 2008 for all hospitals in America to go to an electronic medical records system, but Dr. Young said that Congress never really went along with that goal. When President Barack Obama took office, he picked up the idea and the Congress set a new goal of 2014 and added a caveat that hospitals that don’t meet that deadline could see a cut in their reimbursement rates — federal funding.
“Sierra View has gone far beyond those requirements,” said Sulger of the federal goals. He said while it is a four-year project, much of what the hospital needs to do to meet federal requirements will be done by November of this year.
However, it will not make the hospital completely paperless, but the goal, pointed out Shimamoto, is to be be “paper light.”
When the paperless records system goes live, everything from patient registration to surgery will be charted electronically. Documents that require a patient’s signature will still be on paper.
In essence, a baby born at Sierra View after November of this year will be charted electronically. Their chart will not become one of thousands the hospital must store and secure for years.
All of those involved stressed the effort is to make for better patient outcomes.
“We want the facility to be a place where we can show we provide real quality medical care,” said Dr. Young. “The focus right now is to have a system that improves the care of our patients.”
He said his patients, when told of the plan, were excited, especially the elderly patients. “It’s pretty exciting,” he said.
Sulger agreed, saying patient safety and health outcomes are both benefits of a paperless system, which add up to patient satisfaction. “It makes a lot of difference from a customer service standpoint,” he said.
“It shows the community we are involved. If we do this, it will put us on the leading edge,” added Young.
Part of that first goal to be accomplished in the next 10 months is to get nurses and doctors in the hospital onboard with electronic charting. The hospital already is digitized in radiology and lab and uses an electronic medication dispensing system. That computer double checks medication orders to ensure they will not adversely interact with another medication the patient is already receiving.
What the patient will mostly notice is a small wristband with a barcode. That will be used to identify a patient while they are in the hospital and cut down on medical mistakes. Care providers will have to ensure they have the correct patient by checking the bar code electronically before proceeding.
Another advantage is the “real-time information.”
Chief of the Medical Staff Dr. Bill Goodin said, “the excitement is providing the instant access of this information and providing better care.”
In addition, eventually the system will give patients instant access to their medical records and will make it much easier and quicker to transfer records to another facility if needed.
Drs. Young and Goodin have the task of bringing on board to a paperless system the more than 70 physicians who have privileges at the hospital. Young will serve as “the bridge” between the hospital and the doctors.
“That’s my job, to help people change,” he said.
Dr. Goodin pointed out that going to a paperless system is not an inexpensive effort by doctors. He estimated it will cost in the neighborhood of $70,000 for a doctor to switch their office to paperless charting.
“For a doctor to go to a paperless system, that’s a profound obstacle,” he said of the cost.
However, while doctors are being encouraged to move to a paperless system in their private practices, it is not required. The first goal is to get the doctors’ input and buy-in with the paperless system in the hospital.
There are many challenges that lie ahead for the hospital.
First, more than 350 nurses need to be trained, as well as all the ancillary services such as lab and radiology. Part of the $13 million price tag is training. Dickson estimated between 60,000 and 70,000 hours will be invested in the endeavor — much of that training. Staff is already going through classes.
The other big hurdle is cost.
“It is an independent venture,” said Sulger, explaining the hospital has not received any grant money, although they have not ruled out seeking grants if they become available. Right now, the $13 million will be paid with profits from hospital operations.
The hospital has contracted with MediTech, a national company that has assisted more than 2,000 hospitals to become paperless. Key is that the hospital is benefiting from the attempts of others.
“We’re taking advantage of what has been learned, the best practices from around the world,” said Young. Dr. Goodin added, “There are a lot of challenges to be overcome in bringing this technology into practical use.”
And, the odyssey does not end in November. The project runs through 2014, when officials hope everything in the hospital will be paperless.
“The whole idea of this process is it is not one step. It will evolve,” said Dr. Young.
However, officials have decided to switch much of the hospital’s operations to paperless all at once, instead of phasing it in.
“It’s called the big bang approach,” said Shimamoto. “If we do it in phases, it would be a hybrid” and not as effective.
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Autor(en)/Author(s): Esther Avila
Quelle/Source: The Porterville Recorder, 15.01.2011
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