The digital revolution will soon be hitting a doctor's office near you – if it hasn't already.
Bay area health care providers are spending hundreds millions of dollars to turn their systems paperless and store electronically everything from registration and billing information to X-rays and blood test results.
Digitizing the process will change everything from admitting practices – such as palm scanning – to a nurse checking a barcode on a wristband before she gives you medication at your hospital bedside.
Organizations say it can bring better safety and efficiency, even though it can seem reminiscent to Hollywood-style dystopian technology seen in movies such as "Gattaca."
BayCare Health System – the nonprofit corporation that runs 11 hospitals including St. Joseph's and Morton Plant – is among the first local providers to implement these changes on such a large scale. The company is digitizing records that cover about 2,700 hospital beds, 10,000 clinicians and thousands of patients. "Everything that you could possibly want to know about your patients is available in a click," says Pat Donnelly, BayCare's vice president of patient care services for St. Joseph's Hospitals sand South Florida Hospital in Plant City.
"More than implanting software, it changes the way we're providing care," Donnelly says.
The system rolled out phase two of the "Beacon Project" in August. When a nurse or doctor accesses patients' files, everything from the reason they're at the hospital to how they felt the last time they took their medication pops up in the virtual chart.
BayCare plans to spend $200 million over five years to go paperless.
They're not the only hospital spending big bucks, though.
Tampa General Hospital will invest $120 million over five years to convert to an electronic system, says Elizabeth Lindsay-Wood, senior vice president and chief information officer for the hospital.
"We don't expect we'll get a (financial) return on this," Lindsay-Wood says. "We're expecting improvements in quality and safety. This is really bringing health care into the future."
The hospital will debut its electronic system at the TGH Family Care Center, 2501 W. Kennedy Blvd., and Outpatient Rehabilitation Center, 509 S. Armenia Ave., in mid-2011. From there, it aims to launch the digital system everywhere else (including the main hospital campus) by late 2011.
At the onset, it is expensive for providers to redesign complicated workflows, but they say electronic medical records will increase patient safety and decrease hospital inefficiencies. And those in the throes of change say the process works not just in theory, but in reality, too. "We input and our results come back electronically so our turnaround time for our patients is much faster," St. Joseph's Hospital nurse Amy Jaramillo says.
"Not only can the nurses see the information faster but so can the physicians – so their plan of care is much quicker than before."
Hospitals and doctors have a financial incentive to update their systems – and penalties if they don't. Health care providers who go paperless by 2011 are rewarded in the American Recovery and Reinvestment Act. They get an incentive payment that's equal up to 75 percent of Medicare allowable charges the first year, with a maximum payment of $15,000 that will keep decreasing until 2016.
Providers who aren't in an electronic system get penalized starting in 2015, when doctors will receive 1 percent less in their Medicare and Medicaid reimbursement for each year they delay. The cut caps at 5 percent. "As goes Medicare so goes the rest of the marketplace," says Jay Wolfson, director of PaperFree Florida, a public-private partnership aiming to integrate electronic prescribing hardware and software.
The first regional initiative, backed by a $6 million federal stimulus grant to the University of South Florida, PaperFree Florida will attempt to get at least 1,000 physicians' offices in 11 counties to switch from paper to digital charts.
"It's going to affect the health quality, safety and access of tens of thousands of patients," Wolfson says.
That's also why Tampa General Hospital will subsidize electronic systems for its physicians who want to use the same software provider up to 85 percent. "That will help motivate doctors," Tampa General chief medical informatics officer Rich Paula says. The Florida Medical Association, an advocacy group for physicians, believes that digital records are a must for doctors.
"The incentive money is only a small part of the importance of electronic health records," spokeswoman Erin Van Sickle says. "All of the quality initiatives and reporting will depend heavily on EHRs."
The association believes that it's such an important development, it hired an informational technology team to do 15 seminars for doctors around the state starting in January.
But where there's big money and bureaucracy, there's controversy.
While health care providers have an economic incentive to go electronic, the Food and Drug Administration has yet to set up any kind of software and system standards.
And while hospitals say patient information is safe, there's always the privacy risk.
"Privacy is only going to be as good as the control system in the software," Wolfson says.
Like the breach that happened to a Michigan-based hospital chain that uses Cerner, the same software vendor used by BayCare and Moffitt Cancer Center.
A report from the Huffington Post Investigative Fund found that Trinity Health System computers began swapping medical records in June, causing doctors to unknowingly put wrong information into patients' files. Less than two weeks later, Trinity found its nurses weren't getting digital orders from pharmacies, prompting a four-hour shutdown of a system that serves 10 hospitals.
The Midwestern health care provider says it was a "technician error" and "coding issue" that caused the hiccup.
Even though he's an advocating for physicians, Wolfson says it's also in the patient's best interest to have digital records.
"They reduce costs, errors in prescriptions, redo's on tests that get lost. Patients and their families need to be part of this. The info that's provided by them can be use for them," he says.
Prencis Hampton, who recently had laparoscopic knee surgery at St. Joseph's Hospital, agrees that an electronic system may be better for patients like her, who says in previous hospital visits she had to repeat information to several people and things still got lost.
"It isn't so frustrating, for them and me," Hampton says from her bedside. "You can't lose as many computers."
Thanks to http://www2.tbo.com/content/2010/nov/12/140044/medical-providers-make-healthy-investment-in-digit/ for sharing this.
