|
By Jim Nicholson
Everyone recognizes
the importance of medical records when it comes to medical treatment.
One's doctor keeps copious medical notes. Every time one is admitted
to a hospital, a medical history is taken. Every time one is referred
to a specialist, a new medical history is taken and added to that
doctorÕs file of records.
One is constantly
being asked about past surgeries, as if precise dates of minor
surgical occurrences actually remain in one's brain after twenty
or so years. One constantly needs to supply one's list of pharmaceutical
allergies, ignoring the fact that, of course, drug names do morph,
prescription drugs become generic drugs and, for example, next
to no one remembers what aureomycin is (or was) and, even if your
mother made certain you knew you were never to go near it, the
contemporary medical response is, more often than not, a confused
look, a shrug and a request for the spelling. And what was that
drug that made your tongue swell when you were seven? And, to
make life more difficult, how does one know if there was a history
of any number of diseases in oneÕs family, if one's family never
discussed or even knew of extended familial medical histories.
Even more
frightening (one only need remember Heath Ledger) is the possibility
of prescription drugs prescribed by different doctors lethally
interacting in your body. Or, should you or a member of your family
be on a drug like coumadin where weekly readings are paramount
not only to one's health, but also to one's life, why does it
take so long for the drug test to be read, transcribed and, ultimately,
reported to the patient? The medical records are being kept, but
access to those records seems to be all too haphazard.
More to the
point, what happens to those records? Should you have had the
experience of repeatedly admitting a family member to the hospital,
you soon realize a fresh medical history has to be supplied on
each admittance—to the same hospital. In an emergency situation,
the aggravation is only diminished by the panic of attempting
to remember the entire medical history pronto before a true crisis
occurs. If you've been unfortunate enough to have had that experience,
you have just cause to curse and pointedly ask, "Isn't there a
better way?"
At SSM Health
Care, depending upon your facility and physician, the better way
already exists or is imminent. "Since medicine began," points
out Dr. Richard Vaughn, Corporate Vice President for Clinical
Decision Support at SSM Health Care, "medical records have been
hand-written. Contemporary physicians spend 30 percent of their
time with a patient looking for information. We decided it was
time to match the process with contemporary reality." In essence,
records that were written by hand and kept in paper files were
to be entered into computers and stored in a giant computer bank.
In 2005, SSM
Health Care vetted vendors and settled on three finalists. These
finalists, then, presented their programs to a selection committee
composed of healthcare professionals from across the SSM Health
Care medical spectrum—doctors, nurses, therapists, pharmacists,
representatives of all the people who would be using the program
were allowed to decide which one program would best fill their—and
their patients'—needs.
The new system,
Epic, is designed for swift, comprehensive interplay of a patient's
entire medical history. Everything virtually everyone connected
with a single patient has to report about that patient is electronically
stored on one "chart," which is then accessible to the patient's
entire medical team. A patient need report only one medical history;
once entered, the history is history and additions are made accordingly.
The interface in the system allows all prescribed (and supplemental
non-prescription) drugs to be tracked and alerts clinicians of
patient allergies and drug interactions. Should an operation be
necessary, virtually everything connected with that operation
is logged into the system. Of course, complicated systems take
time for proper implementation. A transition team trained in Madison,
Wis. (home of Epic) for six months to learn the system. It took
another one and a half years of meetings to determine the proper
configuration of the system for SSM Health Care. The program went
live at SSM St. Joseph Hospital West in Lake Saint Louis for the
first time on March 30, 2008. Once implemented, SSM Health Care
has not looked back. A sister hospital in Madison, Wis. is already
online, St. Joseph Hospital-Kirkwood will be online September
21 and the rest of the SSM Health Care will follow.
Our mantra
is "Safety, quality, efficiency, satisfaction" Vaughn explains.
The fail safes in the program are reassuring. "We have a highly
redundant backup in our data center," Vaughn continues. "In each
case we have a dual system with two Internet connections and utilizing
two providers. It's one of the most redundant systems our vendor
has ever seen".
On site, the
system is equally sound. "At SSM St. Joseph Hospital West", Director
of Public Relations and Marketing at St. Joseph Hospital West,
Deena Fischer points out, "we added 300 additional workstations
to our 125 bed hospital. This includes stations on the wall of
patient rooms, hallways and workstations on wheels." No one will
be waiting in line to enter necessary information. All pharmacy
entries into the system are bar-coded and, if the code does not
match, the system will automatically reject the entry. This is
the industries best practice to help ensure patient safety.
At SSM Health
Care facilities, patients will no longer have to rely on fading
memories of their total medical history, patient relatives will
no longer have to complete the same medical form over and over
again upon each visit. After all of the hospitals in St. Louis
complete the implementation of Epic on their campuses and at the
physician offices, patients will be able to access their chart
and lab results online through MyChart. Without having to turn
page after page to find needed information, doctors can even devote
30 percent more time each visit to the patient.
MEDICAL REMINDERS
from UnitedHealthcare
Online personal health messages are the key to a new service provided by UnitedHealthcare. Designed to motivate subscribers to seek preventative health screenings, the messages are based on age, family medical history, past illnesses and unique needs and arrive by e-mail, postal mail or when a subscriber calls customer service.
Seventy-five percent of United States healthcare treatment can be attributed to chronic diseases, which are among the most preventable of illnesses. Reminding subscribers to seek preventative care can result in early diagnosis and limiting what may become a large medical problem to a minor medical issue.
Surveys indicate that individuals receiving such messages were 82 percent more likely to get a cervical cancer screening, 31 percent more likely to get a cholesterol screening and 71 percent more likely to schedule an office visit to have their blood pressure checked. |
