KC Arnold suffered two major blows during Hurricane Katrina. Arnold, an advanced nurse practitioner trained in diabetes care, saw her house severely damaged--but fortunately, not flooded. And a week after the storm, she learned the clinic where she had worked was moving. Faced with a near-impossible commute, Arnold sprang into action, determined to maintain a diabetes practice in her home town, Ocean Springs, Mississippi.

It was a shoestring effort--one funded by a home equity loan Arnold took out on a business plan she wrote in one day. "I had no time to agonize over each decision," she said. Her initial electronic health records budget for hardware, software, and implementation was $25,000. Arnold had used an EHR at her former clinic, and wanted to reinstate the technology at her new business venture. She managed to do that--by installing the software herself. Her work won her the HIMSS Davies Award for ambulatory care, an annual recognition for innovative deployment of EHR technology. According to Arnold, who spoke at HIMSS11 in Orlando, she is the first nurse practitioner to win the Davies Award.

Arnold uses the EHR to track clinical metrics of her diabetic patients. The software enables her to maintain individualized insulin regimens and includes an HL7 interface to the local lab, which ports results directly into the chart. When Arnold opened The Diabetes Center on November 1, 2005, she had three staff members--and learned to do her own billing, after hours. Today she has expanded to five employees and is looking to further expand. Her practice treats patients over the age of 13, and fills a care gap in the community for diabetic patients, she said.

She credits emerging technology as a real plus to tending to diabetic patients. Arnold's patients bring their glucose meters to their visits, and she can download information directly from them into the chart. The data converts into a PDF, which is appended to the patient record. "I have one place to look for records," Arnold says.

Last October, The Diabetes Center launched its patient portal, which grants patients direct access to their chart and enables them to send secure messages to Arnold.

Arnold praises technology, but also underscores the importance of keeping it in perspective. During patient visits, she faces the patient directly at her desk; turning the computer screen so both she and the patient can see it. "You should focus on the patient, not the computer," she said.

For more information about the Davies Award, including documentation submitted by the winning organizations, go to himss.org/davies/index.asp.

--Gary Baldwin


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