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Switch to electronic records seen as ‘monstrous’ benefit

Thursday, February 6, 2014

by Ed Moreth, Sander County Ledger

Clark Fork Valley Hospital's switch to electronic medical records took place in August and while there are minor bugs, the transition has been incredibly positive, according to hospital officials.

"Overall the Epic implementation program has been quite successful," said Dr. Gregory Hanson, CEO and president of the Plains hospital. Hanson said the new system resulted in several new patient safety measures, including drug and drug interaction testing and allergy testing. "A much broader range of information is readily available to medical providers as they treat patients," said Hanson, who's been with CFVH for nearly 20 years. "Patients can also benefit from, and have expressed appreciation for, the ability to have access to their medical records from a computer at their home," added Hanson, a benefit reiterated by Randy Mack, a senior physician's assistant.

Mack, who has been a PA since 1998, said the switch to electronic records has been a "monstrous benefit," saving time for the medical staff and patients alike. "The biggest advantage is the centralization of our records and the quick access to those records," said Mack. Records in the past had to be pulled each day, and then distributed to the medical staff members. The records later had to be put back in place after each appointment. Presently, the staff can bring up a patient's records in a matter of seconds in the exam room.

"There was an initial period of growing pains that we had to work through and there are occasional issues that still need to be worked out as we encounter situations we haven't seen before, but, overall everything is up and running," said Dr. Ronald Black, a hospitalist and obstetrical provider there since last January.

About 150 staff members went through the training for the new system. Specialists from EpicCare, the software program used by CFVH, and staff members from St. Patrick Hospital in Missoula, which works closely with CFVH, played a big part in training the Plains staff and getting the system operational, according to Mack.

"It is fairly intuitive, but it is also extremely detailed and that same robust functionality contributes to a significant learning curve," said Carla Neiman, CFVH's chief financial officer. Neiman said that to maximize the use of the Epic system, many of the routine processes had to be reconsidered, which she said was challenging for the staff. "Instead of asking how Epic fits into the former routine, we have to ask how the former process needs to change to maximize the value of the electronic health record," said Neiman. "I think the general consensus is that Epic is a very functional and robust tool," she said.

Neiman related that a thorough study was done more than a year before implementing the electronic health record (EHR) system, which included on site visits and demonstrations. The federal government mandated that all hospitals must be converted to an EHR system in 2015 as part of the Health Information Technology for Economic and Clinical Health Act. Mack said the change saves an enormous amount of time and once a person learns the software program it's easier to review a patient's medical history and send prescriptions to a drug store, a task that had been handwritten and faxed over to a drug store under the old system. Epic means the prescription is nearly instantaneous and no more handwriting analysis is required.

"In the past, tracking down information, such as test results, medication lists, previous visit information, required finding and opening a paper chart and sifting through the papers inside to find the desired information," said Black. "With the EHR that process is much simpler and streamlined. Information, such as lab results, medication history, x-rays, and prescriptions, can be retrieved with the click of a few buttons. In addition, legibility errors are eliminated," he added.

The instantaneous transfer of information is a big benefit, said Black, which also includes medical personnel from other hospitals and clinics that use the Epic system. "When information is entered into the system at one location, such as in a clinic visit, it is immediately available anywhere else in the system, such as the emergency room or the hospital," said Black. Those same records are available at other Epic locations like St. Patrick Hospital in Missoula. Epic is the most used EHR system in the country. Misplaced or lost hardcopy medical records are also a thing of the past, and the reduction of record storage is a big benefit, he said.

Black said that with the Epic program he can complete a patient's chart in 50-75 percent of the time it used to take with the hard copy method. "With the electronic ordering system and electronic laboratory result reporting, several man hours per week are saved," said Black. "With a paper system, time was spent generating paper orders and reports and delivering them to their destination. Now this is done electronically," added Black, who compares the electronic versus paper program to using email rather than sending a letter through the U.S. Postal Service.

Mack noted that recently an out-of-state hospital called to get the records of a Plains patient who had an appointment there. He said the digital records were of immediate access to the requesting doctor, something that would have been unheard of a year ago. "The program brought a number of patient safety measures into use, including drug and drug interaction testing, drug and allergy testing, and bar code scanning of medications prior to administration to the patient," said Hanson.

In addition, using "My Chart" software, a patient at home can see his or her own medical records, with only few restrictions, said Mack, who can also bring up a patient's records from home or another clinic. "Often, I will review a patient's vital signs, laboratory results, etc. from home before I leave for work in the morning," said Black. "This means I can hit the ground running when I actually get to the hospital."

Mack said there are hardly any drawbacks to the new system, which cost about $1.25 million to implement. The federal government will reimburse some of that cost as the hospital reaches goals in meaningful use implementation.

"The system failures I have experienced affected not only Clark Fork Valley Hospital, but all the Epic hospital systems in western Montana, Idaho and Washington," said Black. "The computer management folks have been able to get us up and running within a few hours. Although it has been inconvenient, we have not experienced any catastrophic events," he said.

Power outages, common in Sanders County, don't impact the hospital because the building has a backup generator, which automatically kicks in when a power failure occurs. Black said outages are hardly even noticed. In addition, the system is backed up in an external storage with redundancies in place to prevent data loss.

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