Staff Photo by Charles Boothe:
Mike Dorsey, an EPIC trainer with Carilion Clinic, works with nurse Ruth Carey on Carilion Franklin Memorial Hospitals new Electronic Medical Records system. Less than 2 percent of hospitals around the country now have an integrated EMR.
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Monday, September 7, 2009
By CHARLES BOOTHE - Staff Writer
The days of patient charts hanging at the foot of hospital beds and stacks of patient files on desks are over at Carilion Franklin Memorial Hospital.
In fact, a new records-keeping system now in the place at the hospital is revolutionizing virtually every employee's job and helping insure a "continuum of care" for patients.
Bill Jacobsen, CEO of CFMH and vice president of Carilion Clinic, said the hospital now has an Electronic Medical Records (EMR) system, called EPIC, up and running. It's a state-of-the-art computer model that centralizes all data related to each patient.
"It even includes billing information," Jacobsen said, pointing out that less than 2 percent of hospitals across the country have fully implemented EMRs.
"Carilion is on the cutting edge of this," he said, and by early 2011 every Carilion hospital, clinic and physician practice in the state will have the system.
The advantages of EPIC are many, he said, because all information about a particular patient is at the fingertips of doctors, nurses or anyone in the Carilion system that is involved in the patient's care.
From the time a patient checks in, information is fed into the EPIC system, he said.
Nurses, for example, make their rounds with COWs (Computers on Wheels), plugging in data about everything they do with the patient when they do it.
If a doctor needs to see an X-ray or MRI result, Jacobsen said, they can quickly retrieve it electronically, rather than the old-fashioned way of sending around copies of the image in envelopes.
"Our physicians can even do this from home," he said, because EPIC can be accessed from their home computers.
"They (physicians) can pull up patients' charts at home and see the latest notes (related to their care)," said Ursula Lee, information technology director at CFMH. "That continuum of care is provided."
Such access allows a faster response that will be based on all available information about the patient, and that timeliness is crucial, she added.
"The nurses are charting immediately, so that can be shared with physicians -- it's the timeliness of patient care," Lee said.
Jacobsen said another aspect of the timeliness is that everyone who needs to have access can do so at the same time.
"They can look at it (a patient's file) simultaneously," he said, even if other physicians from, for example, Carilion Roanoke Memorial are consulted. That hospital, along with Carilion hospitals in Tazewell, the New River Valley and Giles County now have EPIC with hospitals in Lexington and Bedford coming on line next year.
Pharmaceuticals are also integrated into the EMR system, with prescriptions and exact doses known immediately. Medications are electronically dispensed from a device called Pyxis that has been integrated with EPIC.
The hospital has been using Pyxis for four years, but it will be upgraded this month, according to Gareth Darby, the hospital's clinical informatics director.
With the upgrade, bar codes will be used for the patient and the medications.
"If an error is made, the machine will not dispense the medication," he said, adding that the bar code will identify the patient with the medication and confirm when the patient receives the medication.
All of this means more thorough and safer care for patients, Darby said. "Everything we do ... is for the patient's safety and care," he said. "We want to make sure we get it right."
"People may see this as a little cottage hospital," he said. "But we are connected to a huge system, and we can now do a lot more."
Even if a hospital is out of the Carilion system, the information can still be transferred by email, Darby said.
Not only do physicians and staff have access to a patient's file when necessary, so will the patient when the software is in place.
Darby said once the software is ready, patients will be able to go to their local physician and get a PIN (personal identification number) number that will allow them to go on the website and access their medical records.
Besides all the benefits for patients, EPIC eliminates virtually all of the paperwork.
No longer will the cumbersome process of compiling paper charts, filing them and retrieving them when needed be involved. It's all electronic and instantaneous.
"A lot of trees died for health care," Jacobsen said.
"Initiating the EMR system in the Carilion Clinic system has been a long process, one that started in 2006," and has included the conversion of about 780,000 patient records into the new system, as well as installing more than 500 new computers and training 5,000 staff members, he said
"We looked at two major systems (in 2006), EPIC and Cerner," Jacobsen said. "EPIC just fit more closely with Carilion Clinic's physician-led, patient-centered model of care. EPIC is one of the leading players out there and UVA is now going with EPIC, and it's already at the Mayo Clinic."
But the EPIC ball really started rolling at CFMH almost three months ago when training started.
The conference rooms on the third floor of the Carilion Medical Office building were converted into training rooms, Jacobsen said, and Carilion Clinic trainers started rotating through the hospital, making their presence known by wearing "green shirts."
Part of the training included simulations, a form of rehearsals, Jacobsen said, and the EPIC system went "live" in the early morning hours of Aug. 29.
Although Jacobsen experienced the expected anxiety about how things would go, all agreed it went much better than expected, he said.
"It's been far smoother than I expected it to be," Jacobsen said. "It took about three days for everyone to feel comfortable with it, with some feeling comfortable immediately. We faced fewer issues (with implementing EPIC) than any of the other hospitals."
"No one has cried, and that's a good thing," Lee said. "The staff was incredibly prepared with their training."
"They are keen to go forward," Darby said. "If it is for the patient, they will do it."
Jacobsen said switching to EMRs is one of Pres. Obama's goals for all health care providers, so it's even more timely that CFMH is one of so few hospitals in the country that has made this move.
"If the President has his way, it (EMR) will spread across the United States," Darby said. |
