Adopting Electronic Health Records at Bloomington Hospital and Health Care System - Literature review Example

OUTLINE ELECTRONIC BLOOMERS GO PAPERLESS Thesis ment: To improve service to a network of facilities and alleviate problems in providing patient records to physicians and other health care personnel, Bloomington Hospital switched to Electronic Health Records (EHR) system purchased from McKesson Corporation and gained efficiency in improving management of records and personnel acceptance. I. Bloomington Hospital needed to change the health records system to improve service to a network of facilities and alleviate problems in providing patient records to physicians and other health care personnel. a. The hospital is an integrated healthcare network serving ten counties in South Central Indiana. b. The hospital needed to improve its health record system to increase efficiency of health care and reduce cost for resources. II. Bloomington Hospital switched to EHR which was purchased from McKesson Corporation. a. The first phase of deployment included solutions for revenue cycle management, scheduling and to electronically document patient care. i. EHR spared the patients from redundant tests and history-taking. ii. EHR gave physicians and other authorized medical personnel access to updated patient information. b. The second phase of deployment included solutions for improving medical imaging and diagnostic quality. i. EHR reduced the time for delivery of and access for important patient data and image results. ii. EHR reduced the cost of films, papers and personnel operations. iii. EHR dissolved the communication barrier between departments. III. Bloomington Hospital gained success in improving management of records and personnel acceptance. a. With EHR, both clinical and administrative applications improved. b. With EHR, success was manifest in the hospital with 100 percent acceptance. IV. Bloomington Hospital looks forward to more improvements in health care through IT solutions. ELECTRONIC BLOOMERS GO PAPERLESS For more than a century already, the Bloomington Hospital and Health Care System (BHHS) in Bloomington, Indiana has provided health care as a non-profit regional referral center (McMath, 2008). It celebrated its centennial anniversary in 2005 further upholding its mission to improve the quality of health care and applied medicine through technology. That same year, when it was still serving nine counties, patient base already numbered to 367,000 (“Major IT Transformation”). At present, Bloomington hospital’s service has extended to ten counties in South Central Indiana through managing two acute-care hospitals with 380 licensed beds and five physician practices, imaging and pain centers, cancer treatment facilities (McMath, 2008), two urgent care centers and a diabetic center (“Bloomington Selects McKesson”). In addition, there are 160 departments on the main campus (“Major IT Transformation”). This vast expanse of service afforded by the hospital indicates the amount of administrative records and especially heaps of patient health records the hospital has to manage and store. For many years, records were hand-written or printed on paper and stored in file systems. Retrieval, furnishing copies, and delivery of records require a lot of time and resources and may not reach a physician, for example, at the point of care. Thus, they were faced with problems in efficiency of data access, exchange, and delivery. According to Owen Slaughter, chief of BHHS medical staff and emergency department medical director, in 2004, the emergency unit is the primary entry point in the hospital making it the busiest among the departments. The efficiency of getting patients’ medical information and ease of referrals to various physicians essentially guarantee patients that their treatments are coordinated and that the role of the department in the community is accomplished to the fullest (“Bloomington Select McKesson). On the other hand, McMath (2008), vice president and CIO, pointed out that there were more than 90,000 procedures done annually for radiology at different locations. These are carried out by 13 radiologists who often had to drive long stretches to gain access to images in separate facilities. This is at the expense of probably time that could have been spent to attend to other cases thus efficiency is decreased. Hence, the challenge to “provide the right information to the right person at the right time to achieve the right outcome” has been rooted in the vision of the Information Services at the Bloomington Hospital (“The vision”). To improve service to a network of facilities and alleviate problems in providing patient records to physicians and other health care personnel, the hospital has switched to Electronic Health Records (EHR) system and gained efficiency in personnel acceptance and simultaneous data exchange and storage. The paperless environment began to crop up in 2005 (“Major IT Transformation”) through healthcare IT solutions purchased from McKesson Corporation (“Bloomington Selects McKesson”). BHHS allotted approximately $30 million to improve healthcare system with EHR. Among the broad range of IT solutions offered by McKesson, BHHS chose STAR 2000™ Healthcare information system, the Horizon Clinicals™ suite (“Bloomington Selects McKesson”), and a radiology management and picture archiving and communication system or RIS/PACS (McMath, 2008). The goal to go paperless was implemented in two phases. Phase 1 The first phase concentrated on managing revenue cycles, schedules, and radiology. Also, EHR augmented the efficiency of nurses and other caregivers in documenting patients’ health information and histories. Among the vital clinical information included in the electronic records are patient demographics, medical history, and insurance information. After one-time questioning only, these data are available to authorized medical personnel at various secured locations. EHR also ensure that “enterprise-wide” scheduling is taken care of through wireless IT network. Thus, this also increased caregiver mobility (“Bloomington Selects McKesson”). Specifically, one crucial problem common in hospital settings include inadequate information provided to physicians from medical records. These records often fail to give updated results of tests that affect informed decisions to treat or for various other interventions. This problem was addressed through the implementation of Horizon Physician Portal. Its key feature is giving secure access to updated patient data “anywhere, anytime” (“Major IT Transformation”). Physicians are informed of prior test results and other interventions done on the patient eliminating the need for duplicates of diagnostic test results. Any new information from successive visits is added automatically to that particular patient history. With comprehensive information at hand, the primary care physicians are prevented from ordering further tests that may be unnecessary (McMath, 2008). In addition, this physician portal is web-based that the doctors can access patient data anywhere in the hospital and even at their offices or homes. Because there is a central silo for patient data, complete information can be retrieved from a single log-on (McMath, 2008). Nurses and other medical staff can simultaneously view patients’ electronic charts to better attend to patient needs (“Major IT Transformation”) and have more effective coordination with each other. EHR then decreased chart deficiencies by less than 1 percent after a smooth transition from Siemens data center (“Bloomington Selects McKesson”). Phase 2 The second phase not only brought more light to medical imaging but also ease to financial management. How did EHR accomplish these? Through electronic data provided by EHR, costs for films and for delivery of results were eliminated thus increasing efficiency in time and personnel operations (“Bloomington Selects McKesson”). BHHS had decreased expenses for films by over 95 percent. It has saved approximately $330,000 annually. Three personnel were even reassigned to perform other tasks since there is no need to search manually for films anymore (McMath, 2008). McMath (2008) was distinct that speed and efficiency in providing health care are crucial in preserving the quality of care. Likewise, an emergency department (ED) system would not keep patients waiting for long hours anymore just because the results are not immediately interpreted when they become available. With EHR, the results reach the medical staff as soon as these are ready. Moreover, once a patient is admitted, the ED forwards patients’ data to the next facility sparing the patients from redundant testing and history-taking (“Bloomington Selects McKesson”). According to McMath (2008), concrete advantage was specifically experienced by the radiologists who began to gain access to real-time digital images together with comprehensive patient health data. These are the radiologists who had to drive from one facility to another to be able to view and interpret films. They had to travel four days a week to attend to these tasks but this was reduced to just once a week only after deployment of EHR. McMath mentioned the idea to “move images –instead of radiologists” as key feature in the implementation of RIS/PACS. Also, it became a means to link urban and rural areas faster within in the service of BHHS. Furthermore, with 91.3 percent success rate, BHHS met the standards set by the Joint Commission as a Primary Stroke Center. Within only 45 minutes, 80 percent of CT scan results were made available for stroke patients. BHHS achieved this feat in July of 2007 (McMath, 2008). In addition to the relief for radiologists and other physicians, the RIS/PACS also dissolved communication barrier through simultaneous data exchange between departments, for example, from ED to bedside. Truly, communication holds a pivotal role in sharing expertise to better understand a patient’s condition and make more sound diagnoses. For ED doctors carrying out discussions in real-time with radiologists and other physicians, they share expert opinions about the case and the appropriate treatment plan. This system eradicates confusions and misunderstandings, delays, and other interruptions in the workflow (McMath, 2008). More benefits Among other improvements besides efficiency in bringing healthcare, administrative department also benefited from EHR. Accounts receivable days decreased from 75 to 58 because of the prompt recording of medical records (“Bloomington Selects McKesson”). It usually took an average of two days to be able to deliver results from the Orange County campus which was 45 miles away from the main facility. With EHR, time of delivery was reduced to less than four hours (McMath, 2008). These improvements in managing administrative and financial records were made possible by STAR 2000™ healthcare information system (“Major IT Transformation”). Personnel Acceptance Service and implementation teams were trained closely by personnel from McKesson Corporation ensuring that the system’s benefits could be employed to the fullest. With the requirements well defined and a detailed workflow plan prepared, the employees of BHHS were equipped with knowledge of how the system works. Pre-install training and one-on-one instructions to radiologists prepared the team for the implementation of these IT solutions that were specifically selected and bought to meet their needs. On the other hand, the imaging center and image storage facility worked independently of the hospital but provided well-organized image-sharing within the health care center (McMath, 2008). The success of the EHR was reflected primarily by the acceptance of the physicians and the entire health care staff. With 100 percept adoption rate by physicians (“Bloomington Selects McKesson”), there have been an average of 635 log-ins a day by the 330-member physician community and an 80 percent usage increase quarterly (McMath, 2008). Indeed, the over-all efficiency in providing health care to patients with the deployment of EHR has been at par with the goals of BHHS in using technology as a tool to further improve the quality of health care. Future plans With the success of the EHR in improving the quality of healthcare in BHHS, future plans have become more promising. The hospital looks forward to implementation of automated medication dispensing cabinets and bedside bar-code scanning to prevent mix-ups and ensure medication safety. Moreover, clinician decision support/ physician order solution and a web-based portal for patients are also looked into to improve health care monitoring for both physicians and patients themselves (“Bloomington Selects McKesson”). Mark Moore, president and CEO, considered the deployment of the EHR in Bloomington Hospital as the “most extensive, well planned, and important endeavors that we’ve [BHHS has] ever taken” (“Major IT Transformation”). These patient-centered solutions have incorporated workflow in the entire health care community at BHHS. Accomplishment of this feat makes Bloomington distinct from other centers in reaching their aim to enhance health care in the region (McMath, 2008). Literature Cited Bloomington Hospital and Healthcare System Selects McKesson to Build Electronic Health Record; Digitizing Operations Will Integrate Care, Improve Patient Safety. Retrieved November 7, 2008, from http://www.tmcnet.com/usubmit/2004/Nov/1088962.htm Major IT Transformation Enables Electronic Health Records at Bloomington Hospital. Retrieved November 7, 2008, from http://www.mckesson.com/en_us/McKesson.com/About+Us/Newsroom/Press+Releases/2005/Major+IT+Transformation+Enables+Electronic+Health+Records+at+Bloomington+Hospital.html McMath, M. W. (2008, February). Bloomington Hospital created a regional network for radiology services with a single-vendor RIS/PACS. Retrieved November 8, 2008, from http://health-care-it.advanceweb.com/Article/Integrated-RISPACS.aspx Additional reference The vision of Information Services at Bloomington Hospital is: . Retrieved November 7, 2008, from http://www.bloomingtonhospital.org/OPage.asp?PageID=OTH000373 . Read More