Information Managers Have a Full Plate
October 2005
Hospital health information managers have a plateful of concerns these days. Their side dishes might vary a bit, but the common ingredient is information technology and how it's transforming the way hospitals manage clinical and financial data.
The main course is electronic medical records and tasks associated with their implementation. In addition, health information managers are wrestling with the often-arduous transition from paper to electronic files; improving their organization's revenue cycle; and training technology users.
For many organizations, including Good Samaritan Hospital in Vincennes, Ind., the transition from paper to electronic medical records has been under way since the late 1990s.
The plan to incorporate information technology into the 230-bed hospital has been simmering even longer, says Wendy Mangin, director of medical records and privacy.
"We are trying to work our way toward electronic medical records for a number of reasons," Mangin explains. "It will make physicians more efficient, help us address patient safety, and reduce paper and manual processes in my department. We see a lot of advantages in working in that direction."
Health information managers' priorities at Good Samaritan and other provider organizations are driven largely by-or are the result of-information technology.
One of the top issues these managers face is how to contend with both paper and electronic medical records, says Sandy Fuller, executive vice president and COO at the American Health Information Management Association, Chicago. "Perhaps the biggest and most overwhelming challenge is managing records in a `hybrid' environment," she explains. "Most hospitals have some combination of paper and electronic records. They might have lab or radiology systems and maybe an electronic medication administration record and are trying to figure out how to merge the data with a largely paper record in an efficient way."
The hybrid environment generates spin-off issues, such as questions of what constitutes the legal medical record and how the two formats can simultaneously satisfy legal, patient and provider needs. Questions also arise about developing processes to retain electronic patient data that follow legal guidelines for paper records, Fuller notes.
Hybrid funk
In Indiana, state law says the legal patient record can be electronic or paper. But Good Samaritan Hospital is pushing toward a fully electronic medical record to avoid the burden of managing both, says Mangin, the health information director.
"Some facilities have taken the approach that they are going to use hybrid records for a period of time," she says. "That's quite a burden and it's not our approach."
Good Samaritan Hospital has been moving toward an electronic medical records system for more than seven years and laid the foundation by implementing various applications, including clinical documentation from McKesson Corp., San Francisco; radiology dictation from Talk Technology Inc., now part of AGFA Corp., Ridgefield Park, N.J.; and transcription from SoftMed Systems Inc., Silver Spring, Md.
"We had a vision of what pieces we were going to put in and when," Mangin says. "Not that we haven't changed the order of things, but we have steadily added different pieces and made advances since the late 1990s."
Health information management at Northwestern Memorial Hospital in Chicago has labored in a hybrid patient records environment since 2003. But the 725-bed hospital finally has turned the corner, says Julie Bryant, director of information services and medical records.
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