McALLEN — Dr. Juan Salazar used to scribble onto a notepad or dictate into a recorder what he wanted to report from his patient’s visits.
The information the physician gathered eventually ended up in his chart room, where his staff files the paper medical records that are sometimes as thick as books.
A shift to an electronic medical records system at Salazar’s clinic on East Nolana won’t result in a paperless environment that empties out his chart room. But Salazar, who practices internal medicine, said the system promises greater safety and lower costs for his patients in both the clinic and hospital settings.
Doctors Hospital at Renaissance, where Salazar often sends his patients, is asking its physicians to switch to electronic medical records as the federal government adopts guidelines to put all of the nation’s health care providers on computerized records by 2015.
Doctors Hospital will ask its medical staff to forgo the universal practice of updating a medical chart beginning Sept. 20 as it adopts an Internet-based system operated by Cerner Corp., a healthcare technology provider that contracted with the hospital. The hospital’s medical staff will order tests, check labs and input patient information using computer workstations on rollaway carts or the portable iPad.
But the hospital is taking its shift a step further by asking the 300-plus physicians who send patients to the hospital to adopt the technology in their clinics, said Fausto Meza, the chief medical information officer. The ultimate goal is to partner with all of Rio Grande Valley’s physicians and hospitals to develop a communitywide repository of all patient information.
By automating the healthcare process, electronic medical records can reduce waste by cutting out tests already done elsewhere or improve safety by warning doctors about a patient’s allergies, said Salazar, who now inputs notes about his patient’s visits on a laptop he carries with him.
“Whatever information I put into the system will be available to the hospital,” Salazar said. “The information is already there, but it’s going to be on one chart for whether the patient is in the office or in the hospital.”
‘BEST FOR OUR PATIENTS’
In asking healthcare providers to adopt computerized records, the U.S. Department of Health and Human Services is using both the carrot and the stick.
Doctors’ offices and hospitals can get federal money to defray the costs of the systems that promise to deliver long-term savings by streamlining the delivery of medical care. Providers who don’t comply with the regulations by 2015 will face cuts in Medicare payments – a dangerous proposition for hospitals and physicians in the Valley, where most patients depend on the government-aid program.
But Doctors Hospital at Renaissance had been working to implement an electronic medical records system long before the federal government released hundreds of pages of regulations in July, Meza said. A team of the hospital’s physicians went through an extensive selection process last year before opting to use Kansas City, Mo.-based Cerner as its provider.
Other area hospitals are also shifting toward electronic medical records.
Knapp Medical Center in Weslaco began a piecemeal conversion toward computerized records in late 2008, beginning with its imaging services and basic customer information, said hospital spokeswoman Maggie Halaby. Knapp’s physicians can access the records on the hospital’s secure servers, and it’s also asking its doctors to adopt the service in their clinics.
At Doctors Hospital, administrators saw electronic medical records as a way to improve safety and reduce inefficiencies, Meza said.
The computer-based system alerts doctors if they prescribe a drug to a patient who is allergic to it or if the medicine conflicts with another prescription. A hospitalist can avoid ordering a duplicative test if the patient’s earlier results are already available in the system and a physician doesn’t have to comb through three different charts to find a patient’s family history or previous lab results.
Meza, who also touted the system’s capability to give patients control over their own medical records by allowing online access to the encrypted data, said electronic medical records are a “transformational investment.”
“Hospitals will end up spending tens of millions (on electronic medical records). It’s manpower extensive and very expensive,” Meza said. “But we spent the money because the doctors knew that it was the best thing for our patients.”
EFFICIENT EXCHANGE
The Obama administration promotes electronic medical records as a way to slow the growth in U.S. healthcare spending, which now represents 16 percent of the country’s gross domestic product.
Information technology can cut healthcare expenditures by up to $500 million annually by automating tasks such as ordering tests; coordinating interactions between primary care providers and specialists; and reducing administrative costs, which account for nearly one-third of current U.S. healthcare expenditures, a brief by Cerner CEO Neal Patterson says.
A technology-based approach could produce a marked impact on health care costs in the Valley and at Doctors Hospital at Renaissance, which drew national attention during the health care debate last summer for a perceived high cost for medical care.
Driving out redundancies that occur between the hospital and the clinics can reduce costs for communities like the Valley that deal with large incidences of chronic diseases, said Melinda Kinkaid, a Cerner representative who is working with Doctors Hospital at Renaissance. Diabetes patients, for example, often move back and forth between the physician and the inpatient hospital without keeping their health care providers apprised of what the other is doing.
“This is where we start driving down the inefficiencies because they don’t have to redo that work,” she said. “The results of what happened in the hospital are available in the clinic, so we can decrease the inefficiencies and drive down the cost.”
But that takes connecting all of the physician’s offices with the hospitals to ensure all providers are kept in sync, said Scott Dikeman, a Cerner employee who is helping the Valley’s physicians implement the technology. A community repository results in a universal health record for each individual that allows them to move seamlessly between any provider.
In Oklahoma, a publicly operated system organized by a tribal nation now stores medical records for 2.6 million people.
Salazar, the McAllen physician, said connecting the entire community will eventually provide an efficient exchange of medical information.
“The patients don’t always know their history,” Salazar said. “They depend on us for their medical information, and we have it at hand easier with electronic records.”
Jared Janes covers Hidalgo County government, Edinburg and general assignments for The Monitor. He can be reached at (956) 683-4424.
Website: www.themonitor.com/articles/records-41409-electronic-system.html