Someday all your medical records will be accessible all over the world, at a moment’s notice, to anyone with a computer or smartphone and permission to use the correct password.
Even to you.
That day isn’t here yet, and probably won’t be for decades. However, the Redwood Area Hospital and ACMC Clinic in Redwood Falls are in the first steps of making it happen.
“The goal is sharing of information among all the different healthcare) providers,” said Tom Balko Jr., Information Systems Manager at the Redwood Area Hospital.
“We can document the patients’ condition in real time,” said Dawn Allen, Chief Clinical Officer at the Redwood Area Hospital. “We can communicate real-time documentation and sharing with other healthcare providers wherever the patient is, whether in Redwood Falls, or as a snowbird in Arizona.”
“It’s a substantial infusion of new technology,” said Balko. “We have had to buy a lot of additional servers, hardware and software, and set it up beside and at work stations, wherever people need to work with it.”
For the Redwood Area Hospital, the process effectively began for real on Aug. 13, 2010 — the day the hospital staff made the decision about which hardware and software to buy.
Balko said one problem everyone is dealing with is the flexibility of the equipment provides thousands of options to decide among.
“The systems have to be tailored for each facility,” said Balko. “If you have two small rural hospitals who select completely different systems, with their own goals, styles, and parameters. The two final records keeping systems could be as different as two snowflakes.”
One of the biggest problems — aside from the fact it’s a totally new system and everyone’s making it up as they go — is making sure all software and hardware is compatible.
“That issue is always going to be there because of the free market and there’s always going to be more than one vendor,” said Balko. “The government is having to put into place ways information can be shared at (different hospitals and clinics that use different equipment.)”
That confusion even exists locally — the Redwood Area Hospital and ACMC Clinic selected different software vendors, and don’t have completely compatible systems.
Currently, if hospital staff need access to the clinic’s records, they have to use several special workstations set up at the hospital.
At the clinic, doctors and nurses must go to their office computers to log onto the hospital’s records.
The whole electronics record keeping system isn’t just about hospitals and clinics — pharmacies have access to the relevant parts, also.
Page 2 of 3 - “That was a big jump for us, sending information to the pharmacies electronically,” said John Wittenberg, Site Manager at the Affiliated Community Medical Center in Redwood Falls.
Not just medical information is shared; a patient’s financial and insurance information becomes part of his or her record, too.
Although the goal is to eventually speed up sharing of information, Allen admitted it’s slowing things down at present.
“It takes longer when the patient first comes in today because we have to get all their information into the computer,” said Allen. “The first time a patient comes in, the electronic record creates a baseline. Then, each time a patient comes in, we can track his condition over time.”
From the information the computer generates a general report that can be transmitted out to doctors, pharmacists, etc.
According to Allan, electronic record keeping will eventually “have huge benefits in terms of reducing costs, or duplications of tests.”
Already, the hospital’s home care staff has electronic access to patients’ records when they’re out on the road, visiting in the patients’ homes.
To date, the hospital and clinic have spent several million dollars on electronic record keeping equipment, with no definite end in sight.
“It’s a humungous investment,” said Balko. “We’re setting the groundwork now, but it’s a constantly evolving solution.”
However, although each hospital, clinic, and pharmacy must come up with the up-front fund to pay for the systems, the federal government will reimburse part of the cost if certain deadlines are met.
There are no mandates for everyone to meet, merely incentives.
“If we choose to not go ahead with the program, there will be a cost later,” said Wittenberg. “Eventually hospitals and clinics will close if they can’t access information, or submit bills electronically.”
Balko emphasized there is no definite deadline date when everyone has to have their system “complete”.
“It’s a long-term process, with a lot of the stages still undefined,” he said.
As with any system that depends on electronics, there are many, many levels of backup and security in place. If the hospital or clinic lose electricity, there is enough redundancy built in that the hospital or clinic can still function.
Balko emphasized the system is only in place for patients who have come in during the past couple years.
“Whatever records existed on paper haven’t been put en masse into the computer,” he said. “For someone whose history goes back decades, we still have the paper records.”
Page 3 of 3 - Wittenberg said the ACMC Clinic is currently testing a system called, “Patient Portal.”
“Soon patients will be able to access their own records from their computer or smartphone,” Wittenberg said. “They’ll be able to access test results in real time, and sent text messages or emails to their doctors instantly.”
“There are a lot of challenges, but our staff and physicians have risen to the challenge,” said Allen. “If someone has been doing a job for the same way for 15 years, it can be tough for them to be told the next day they have to do the job completely differently.”