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The Hospital's Role with EHRS
November 1, 2007
Lead or follow? It's an age-old question, and hospital CIOs find themselves struggling to come up with an answer when thinking about their organizations' role with electronic health records. For many, the thinking goes something like this: Well, there are a few big states and insurers with millions of dollars that will create RHIO solutions we can follow, right?
Then the federal government will take all these concepts and solutions and create standards for us, right?
Our vendors will then work with these solutions and deliver them to us in a very affordable manner, right?
And certainly our physicians, patients and community understand these take time to develop, right?
So, let's all relax and wait.
But even at my little 51-bed hospital in Sanford, Maine, we feel we cannot afford to relax or wait. From a clinical perspective, fewer and fewer patients are becoming inpatients. We have an inpatient electronic health record, medication safety and wireless networks. We're meeting the I.T. needs of our ancillary departments, and playing with a toy called RFID.
However, don't we know that hospitalizations may only account for 10% to 20% of a person's entire health care record? That's a lot of technology being used or, in truth, underutilized and/or over-invested in to capture 20% of a patient's treatment history.
Goodall employs more than 20 primary and specialty care providers dispersed throughout 10 practices in the community. We still, however, cannot find enough primary care providers to service the needs of the outpatient community.
Therefore, our emergency department volumes annually are growing in double-digit numbers. When a patient comes to the ED, the patient's primary care office probably is closed-so in today's world there is no access to the patient's medical history.
Even when referring between practices the paper trail is a must-have. Maine is "Vacation Land" and today I can safely say that we have the same standard of care for visitors as we do for Maine residents-i.e., we won't know a thing about you!
That's just great, because as patients we all appreciate being asked the same questions over and over again, and count on the trained and exceptional professionals to treat us without knowing a thing about us. I am sure that Sanford, Maine is not alone in this struggle. So, it's time for hospitals to lead. Look within, reposition ourselves and really take care of the community we serve. Go champion that other 80% of the health care record!
At least that's the concept that we are following here at Goodall Hospital. With only a seven-person I.T. department - and lack of an interface engine - we are on course to create that elusive community health record by following a single, integrated core vendor strategy. Perhaps the biggest fear in I.T. is not knowing how to establish and support physician relations.
The recipe is simple but the execution may be quite complicated: * Fix your own house first. * Have the vision. * Invest in the people and systems that support the vision. * Collect the data needed for patient care. * Make it reliable and accessible to all caregivers.
In this way, and only this way, will you have any credibility and trust that you, the hospital, can possibly have a positive effect on a physician practice. At the very least you will have proven to the physician community that the hospital is worthy of having a conversation with about an electronic health record.
As a community hospital we are in an enviable position of having a "captured" medical staff and operating in a less competitive market. But the community EHR for Sanford, Maine is a path that must be pursued. So far, the building blocks are falling into place to make this a reality.
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