A slip of paper at the nurses’ station indicated a certain medication dose was due for a patient. Dallas Fulton knew better. Actually, his hand-held computer knew better.
Fulton, a registered nurse on staff in Truman Medical Centers’ Hospital Hill intensive care unit, gets real-time electronic information about prescriptions, vital signs and any other aspect of patient care. His “CareMobile” device, never far from his side, quickly showed him that the patient’s physician had just changed the prescription order.
“It’s faster and safer,” Fulton said of the technology. “It used to be that physicians scratched orders on paper, which went to the pharmacy and then to us. Now, the order goes to the pharmacy electronically, and as soon as it’s validated, it shows up in CareMobile.”
The brick-sized portable device, which uses software by Kansas City-based Cerner Corp., goes with Fulton to patient bedsides, allowing him to immediately enter and obtain patient data. It also scans bar-coded patient wristbands to confirm identities.
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This is the quiet side of the changes rippling through health care. A revolution in the conversion of patient information to computer records has spawned a huge industry in health care information technology. It’s created such job titles as “director of nursing informatics,” the job held by Amye Gilio, a registered nurse at Truman.
The two Truman hospitals and the system’s health IT partner, Cerner, are recognized as leaders in IT transformation. The Kansas City-based hospital has achieved the highest level of health IT adoption as measured by Healthcare Information and Management Systems Society Analytics.
Truman reached a “Level 7” status for its electronic health records, a ranking held by less than 2 percent of U.S. hospitals. It’s the only facility at this level in the Kansas City area.
Nationally, about three-fourths of hospitals and about half of office-based doctors have adopted some kind of electronic health records system. That starts with scanning into computer systems the paperwork that has filled the manila folders that have lined the walls of medical offices for decades.
Such scanning was a natural progression into the digital age. But it was hurried along by federal incentive payments provided by the 2009 American Recovery and Reinvestment Act, stimulus legislation designed to help pull the country out of recession.
So far, the federal program has paid doctors and hospitals more than $14.6 billion to install and “meaningfully use” electronic health records by 2014. Truman has received about $12 million in federal incentives.
Since Truman began on the digital path in 2009, it has spent $18 million on implementing electronic health records. Its annual IT budget, which includes an IT staff of 109 employees, has grown to $25 million.
The industry goal is more-efficient health care. By putting patients’ histories and care orders at the fingertips of doctors and nurses, digital records are expected to reduce duplication of services, reduce errors, and improve the quality of care because providers will have better information about what care is working.
According to a study published earlier this year in the Journal of the American Medical Informatics Association, digital records have helped avoid more than 17 million medication mistakes. But a contrary study by the Pennsylvania Patient Safety Authority found error rates doubled from 2010 to 2011, perhaps reflecting growth in digital records use.
There is no central database for reports of errors tied to electronic health records. Some companies, such as Cerner, voluntarily report their technology problems to the Food and Drug Administration. But the FDA doesn’t regulate health IT providers, so there’s no repoting standard.
The Office of the National Coordinator for Health Information Technology, in the U.S. Department of Health and Human Services, is setting some health IT standards for the youthful industry.
Date: July 2, 2013