Hi-tech health

COLUMBIA BASIN — Before Elisabeth Gutierrez comes for her doctor's appointment at Columbia Basin Health Association in Othello, her doctor not only knows when her last visit was but what medications she might be taking and any notes made about her health from other physicians. That is because Gutierrez is only one of many patients throughout the Basin and the state of Washington whose patient records are in the process of being transferred to electronic health records (EHR).

The transition is part of President Bush's call earlier this year to have most Americans transferred to EHRs within 10 years. Working through the U.S. Department of Health and Human Services, Bush's initiative aims to alleviate problems such as medication errors, increase the use of information sharing between health care providers, and ease patient transitions between doctor's offices.

In January of 2000, CBHA went live with their electronic records, a process that CBHA CEO Greg Brandenburg said happened over a period of a few months.

The paper records first had to be scanned onto the EHR system and at first employees used the paper records until they felt comfortable with the new system, Brandenburg said.

New and continuing employees receive training once a week to learn how to use the EHRs which are accessible from every patient room.

Today all three CBHA locations — two in Othello and one in Mattawa — are equipped with computers in each patient room where doctors and nurses can pull up the patients records, eliminating the potential for paper charts to get lost or the doctor from having to step out of the room while seeing a patient.

"We know where every chart is," said Ann Thomas, an RN at CBHA's 14th Avenue Medical Center in Othello. Medical staff can prepare for the visit before the patient even arrives which saves both doctors' and patients' time, she said.

Gutierrez says she is not concerned about patient privacy now that all of her medical records are accessed electronically. "Being able to sit and watch the doctor do it actually makes me feel more comfortable," she said.

Since introducing the EHR nearly five years ago, Brandenburg says his organization has saved money in the long run.

Prescriptions no longer have to be dictated over the phone and what used to take two to three days for transcriptions, which cost CBHA $1,000 per month per provider, was saved just in the first year as the software to make the change cost $12,000 Brandenburg said.

Department cutbacks and additions have taken place since making the change to EHRs.

There were 14 medical records staff and now there are six, with an expanded information technology (IT) department that has five full time employees Brandenburg said. "The whole (healthcare) industry is moving in that direction," Brandenburg said of the move.

At the Moses Lake Community Health Center, patient records have been accessed electronically since 2002.

EMR specialist Carolyn Hutchinson said transferring the patient records a few months before going live with the system was an added benefit.

Since then, Hutchinson says, the benefits have far outweighed the costs of implementing the system.

Hutchinson used the example of the recall on the painkiller Vioxx in September which was found to cause an increase in heart attacks and strokes.

Patients using Vioxx needed to be notified and the EHR system was able to highlight who was using Vioxx and a letter was sent out by noon. Hutchinson said. That type of patient notification would not have been possible using paper records, she added. "Providing quality of care was the reason MLCH put in for the system," she said.

At Samaritan Hospital, the ER department is also using the new technology, but has not fully transferred over.

"Hospital systems are so much bigger and complex compared to physician systems that have more long-term patients," said Michael Cloutier, director of information systems at Samaritan Hospital.

Cloutier says the next step is to continue employee training and transition in other departments throughout the hospital.