Medicineworld.org: Embracing e-records
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Computer monitors are replacing X-ray film and paper files in the doctor's office.Surgeons and staff no longer play the "where's-the-chart?" game in the Division of Cardiothoracic Surgery at Washington University School of Medicine.
That activity recently became obsolete when the division switched from using paper files to a fully electronic medical record system.
"In our division, there might be six people vying for a patient's chart during the week," says Laura Ochoa, advance practice nurse in thoracic surgery. "The surgeon's assistant might have the chart so she can include dictation from the surgeon, I might want it to organize some tests, our research group might want it to see if the patient is eligible for clinical studies, and so on - so we used to end up playing 'Where's the chart?' a lot. With the electronic system, we can all look at one chart simultaneously from our own offices - on the medical campus or at other clinical locations."
By one estimate, only about 14 percent of all medical group practices nationwide use electronic health records. Professional organizations and federal agencies have been encouraging their use, and the federal government has set a goal for widespread adoption in medical practices within the next 10 years. Electronic records are thought to improve the quality of care, reduce errors and improve efficiency.
The electronic record-keeping system adopted by the cardiothoracic division will be implemented throughout the Washington University Physicians group, a clinical practice group of more than 900 physicians representing more than 50 specialties and providing services at more than 35 sites throughout the St. Louis region.
The general thoracic surgery service changed to electronic records this spring, and the division's cardiac and pediatric cardiothoracic surgery services recently implemented the electronic system, completing the division's move away from paper medical records.
"The potential advantages for general thoracic surgery are huge because we see a large number of new patients every week," says G. Alexander Patterson, M.D., the Evarts A. Graham Professor of Surgery and chief of the Division of Cardiothoracic Surgery. "Most of those new patients require a significant number of investigations before we can make a plan for their therapy, so it's an incredible amount of data to manage. Having it in an electronic format has really helped."
Patients may find electronic medical records improve their experience as well.
"The system can be set up to know your preferred pharmacy, and a staff member can just push a button and send a request directly to the pharmacy," says Troy Burrus, electronic medical records program manager with the Washington University Physicians group.
When the entire School of Medicine has installed the electronic system, patients who see more than one specialist could find their visits easier.
"If you've seen your dermatologist and then your internist, they will both refer to the same chart, so there's one list of allergies and one list of medications," Burrus says. "If a doctor discontinues a medication, immediately all the other physicians who see the chart will have that information."
As per Burrus, the system automatically checks for harmful drug interactions and can also signal a doctor if a chosen procedure or therapy is outside of recommended guidelines. With its connections to testing labs, the system can receive blood test results, X-rays and other information electronically. A task list feature that identifies items that need attention ensures patient calls and test results are dealt with quickly.
Patterson says he believes the electronic record system improves patient safety.
"It's far safer and far more complete," Patterson says. "Having everybody in the patient care loop with access to the same information makes mistakes much, much less likely."
The system maintains patient's records on secure servers, and duplicate servers safeguard against data loss if one should become damaged. Security features prevent unauthorized viewing of patient records.
"One of the biggest questions about electronic medical records is security," Burrus says. "There are a number of checks and balances in place to make sure the documents are secure."
The electronic system can save time and cut costs by reducing filing and storage, and its link to the financial system can streamline billing.
Called the TouchWorks Electronic Health Record, the system was developed by Allscripts, a provider of clinical software.
Posted by: Sue Source
Did you know?
Surgeons and staff no longer play the "where's-the-chart?" game in the Division of Cardiothoracic Surgery at Washington University School of Medicine. That activity recently became obsolete when the division switched from using paper files to a fully electronic medical record system.
Medicineworld.org: Embracing e-records
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