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April 4, 2005
Emory Healthcare continues shift to electronic records
BY cindy sanders
Earlier this year, President George W. Bush called on doctors and hospitals to switch their medical records from paper to electronic, which he said would improve medical care while saving the government and other payers money. Officials at Emory Healthcare (EHC) came to this realization more than a decade ago, and the organization is well on its way to rolling out one of the largest health-system-wide, integrated electronic medical record initiatives in the country.
Using technology to transform the delivery of health care is the end goal for the $50 million Emory Electronic Medical Record (EeMR). But the multiyear project is about much more than converting paper medical records to a paperless format; it will increase efficiency and enable health care providers to make the best decisions regarding patient care, ultimately improving quality and safety while reducing costs, according William Bornstein, EHC chief quality officer.
EeMR allows physicians and other health care providers to enter patient information and orders directly into computer terminals. The technology responds with information such as alerts about drug interactions, and even assists with administrative activities such as coding and billing. The project will directly affect more than 7,000 EHC employees at all levels, from doctors to billing specialists.
“The size and scope of this project is unusual,” Bornstein said. “Emory Healthcare is Georgia’s largest and most comprehensive health care system, encompassing three wholly owned hospitals and many clinics across metro Atlanta. It is important for clinicians to be able to view patient’s records from anywhere in the system.
“One thing that makes Emory’s project unique is the level of integration across multiple inpatient and outpatient settings,” he continued. Physicians will also be able to access patient medical record remotely via the web using encryption and password protection.
“EeMR is a fully interoperable system—meaning we are able to communicate, exchange data and use information in multiple settings across our organization,” Bornstein said. “We are able not only to see information across both the outpatient and inpatient settings, but the data also lives in a single database and will trigger decision support across the enterprise.”
Emory has been working with Cerner as a development partner in its electronic PowerChart system since the early 1990s. Phase II of the current initiative (in which Cerner is also a partner) began in 2002 after the completion of Phase I, the installation of the system’s technical infrastructure and hardware, as well as the Enterprise Master Patient Index, software that tracks each patient using a unique internal identifier number.
This index reduces registration errors and reduces the need to re-enter the same patient information in different care settings. It is also used to index the radiology picture archival and communications system (PACS) used to store and display medical images electronically.
The $50 million cost includes a $27 million initial commitment to EeMR, as well as associated technology investments needed to improve clinical workflow and the cost of the PACS system.
“In a system the size of Emory Healthcare, changing over to an electronic medical record is a monumental undertaking. Along with the installation of new technology, extensive education of our staff is required,” said Dedra Cantrell, EHC chief information officer.
Implementation of Phase II required the scheduling of nearly 900 separate training classes. As new software programs went live, 500 ACEs (employees trained as application content experts) were available during each shift to answer questions and troubleshoot problems. Most users have received two hours of classroom instruction, while physicians are being trained individually.
“We are certainly not the only health care organization implementing electronic medical records, but we believe we are taking it a step beyond going paperless,” Bornstein said. “Integration across all settings and types of practices is critical; our clinicians are implanting information into the system that will assist them at the optimal moments.”