Transition to paperless medical records may be prickly

BY TYLER LYON | JUNE 23, 2009 7:21 AM

At a June 10 meeting with the state Board of Regents, UI Hospitals and Clinics officials unveiled a $55 million Epic system. It allows staff to access patients’ electronic medical records across hospitals such as University of California-San Diego and University of Chicago, which use the same program.

But the program doesn’t have a tool that would allow it to “communicate seamlessly” with hospitals with different systems, said Lee Carmen, a UI associate vice president for Medical Affairs.

Yet that is what the concept of electronic records are intended for. To avoid having to file patients’ information repeatedly, digital records are theoretically accessible at all hospitals.

Carmen said the federal government set aside money in the stimulus package to encourage health-care providers to adopt electronic medical records as well as reward those who are making the change.

One of these provisions gives hospitals with digital record systems more coverage through Medicare, starting in 2011 for four years.

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But compatibility between hospitals is just as much a policy issue as it is a technical one, said Dan Fick, a UI clinical professor of family practice.

“It isn’t like it’s between an Apple and a PC,” he said.

Iowa state laws say hospitals can’t share patients’ information without their permission, he said. Patients are also allowed to decide what information is shared.

“I think a misconception is that someone can come to an ER and the physician will be able to pull up that information,” he said.

Another problem in sharing information with other hospitals is in the consequences it may have for other companies that sell systems for digital health records, he said.

“There are many smaller [electronic medical record] companies that don’t want to be eaten up by the bigger companies,” said Doug Van Daele, a UI assistant professor of otolaryngology.

Epic could buy out a smaller system that is compatible.

Van Daele and Fick presented the Epic project update to the regents.

And with the new technology, training staff to use the new system may pose its own challenges, officials said. Fick said every staff member who uses the system was required to go through four hours of training last fall and eight hours in the spring.

“You have to weigh the pulling of people away from normal clinical duties compared to going through every possible work flow,” he said.

Despite the sometimes onerous training process, Van Daele lauded the Epic program for its flexibility and wide variety of features.

For example, physicians have the option to dictate patient information as well as type it.

But he admitted even the system’s flexibility is a “double-edged sword,” and can be “overwhelming to the new user.” And it may be even more difficult for doctors who aren’t computer savvy.

Van Daele said the hospital staff is working hard to make sure “the computer doesn’t get between the doctors and the patient.”

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