Benefits of digital patient record starting to emerge at Rice Hospital in Willmar, Minn.
WILLMAR — To patients, Rice Memorial Hospital’s transition a year ago to a new integrated electronic medical record system was mostly invisible.
But to hospital workers and the medical staff, it was a huge undertaking. And now that the electronic health records system has been in use for a year, the change is becoming increasingly apparent.
Under the old system, the emergency room had a separate electronic health record for patients seen in the emergency room. It was “one of the biggest headaches” of the former system, said Dr. Michael May, a hospitalist who is also the Epic physician champion for the medical staff.
It was inefficient, and there was always the potential that something would be missed, he said.
The new system integrates the ER and makes patient information electronically accessible in most departments, he said. “It streamlines. I no longer have to spend 20 to 30 minutes of my day chasing down paper charts.”
The implementation of computerized physician order entry has eliminated handwritten prescriptions, a known source of medication errors. Automatic alerts pop up if a clinician orders two medications that aren’t compatible or if the dosage is outside the norm.
“I think I’m more efficient with it. I think it’s safer,” May said.
Another feature is standardized order sets and checklists for managing conditions such as congestive heart failure, using evidence-based practices, he said. “It helps prevent things from getting missed.”
Key patient information such as allergies or current medications is now more consistent and more complete. “It’s important to have those readily available,” said Teri Beyer, chief quality officer.
Hospital leaders are finding that the system has helped reduce duplication in ordering lab tests. Overall lab volume at Rice in fact dropped somewhat last year, mostly because of fewer redundant tests.
Some processes actually have improved, Beyer said. When a patient leaves the hospital, for example, Epic generates a post-visit summary containing follow-up instructions, an up-to-date medication list and educational handouts. The summary not only provides patients with information they will need when they get home but also helps close some of the gaps at a vulnerable point in patient care, reducing the likelihood that the patient will end up back in the hospital.
Nationally, electronic health records have their share of critics. The push for health care providers to abandon pencils and paper in favor of digital records may be too much, too fast for many hospitals and medical practices. Although the systems are touted as safer, they have also introduced the potential for new types of errors such as the perpetuation of inaccurate patient information through repeated cut-and-paste.
The road has not been easy, said Kathy Dillon, director of information management at Rice Hospital. Billing, for example, became more difficult because the financial components of Epic are less developed than the clinical components, she said.
“People have had to put up with things they might not like. They’ve hung in there,” she said.
But the electronic health record is the direction in which health care is headed, Beyer said. “It really does reflect what’s out there in the industry. A more integrated, fully electronic record is what we all aspire to.”