Emory Healthcare (EHC) has reached the first milestone
in a multiyear, multimillion-dollar project to achieve a system-wide,
paper-free electronic medical record (EMR). The adoption of EMRs
is a key goal for many of the country’s largest hospitals
and health systems in their quest to improve quality of care, lower
the incidence of medical errors, increase patient and provider satisfaction,
and adopt standardized decision support and treatment pathways based
on medical literature.
EHC began developing the infrastructure for the EMR in 1992. For
the past several years, both inpatient and outpatient records have
been entered, stored and retrieved electronically from the same
underlying, secure database, said Dedra Cantrell, EHC chief information
Now, all new patients are assigned a unique identifier that eliminates
the need to re-enter the same information in different care settings.
Cantrell said she believes Emory’s is the first large hospital
system in the Atlanta area to achieve this degree of data integration
for both inpatients and outpatients.
This system embraces patient data for Emory University Hospital,
Crawford Long Hospital, The Emory Clinic, the Wesley Woods Center
and will include the Emory Children’s Center, amounting to
more than 40,000 inpatient admissions and 1.1 million outpatient
visits a year.
Meeting this important milestone means that EHC is on target to
implement system-wide computer-based physician order entry (CPOE)
by December 2004, said William Bornstein, chief quality/medical
officer for Emory Hospitals and medical director of information
services for EHC.
“The Emory EMR system, which will include CPOE, and full outpatient
and inpatient care systems, will allow us to capture real clinical
data in the process of care,” Bornstein said. “We will
be able to feed this clinical data into a common database that will
allow us to do very robust analysis and reporting from a research-
and patient-outcomes perspective. In this way, continual performance
improvement and quality assurance will be built into the cycle of
CPOE has been advocated by healthcare quality improvement organizations,
which see it as a key step in minimizing errors. Not only does CPOE
eliminate imprecise and incomplete communication between doctors,
nurses and pharmacists, but it also provides real-time clinical
decision support, which helps to reduce adverse drug events and
Bornstein noted that another important feature of this system will
be the seamless capture and documentation of insurance and other
administrative information, which increasingly occupies doctors’
and nurses’ time.
“Rather than technology interfering with the high-touch aspects
of health care, we think technology will actually enhance it, by
off-loading multiple documentation requirements, managed care formularies,
and all those things that can interfere with the personal aspects
of a patient encounter,” Bornstein said.
The end of all paper patient records at Emory in both the inpatient
and outpatient setting will be an important milestone of what is
projected as a $27 million program, launched in July 2002 and ending
sometime in 2012.
“This is not about going electronic for the sake of going
electronic. This is not about automating the paper medical record,”
Cantrell said. “Although a byproduct will be elimination of
the paper medical record, this initiative is really all about transforming
care at Emory.”