Electronic Medical Records

Most hospitals handle their patient charting, medication ordering and critical communications through handwriting that is often illegible — a method the Obama administration intends to change for all Americans by 2014.

A centerpiece in President Obama’s efforts to reform health care is in the adoption of the electronic medical record (EMR) that promises to lower costs and improve quality. This revolution is bringing an end to millions of manila folders holding countless pieces of patient information and scribbled notes. In their place are EMRs that can transport patient information in real time with the click of a button.

To learn more, Smart Business turned to executives at MemorialCare Health System, a pioneer in computerization of medical information. Steve Geidt is CEO of Saddleback Memorial Medical Center, whose Laguna Hills campus was the first Orange County facility to fully “go live” with electronic medical records. Marcia Manker is CEO of Orange Coast Memorial Medical Center in Fountain Valley that is completing its EMR implementation.

What is an Electronic Medical Record (EMR)?

Manker: Electronic medical records place the patient’s full medical history into computers and information systems, allowing clinicians to better coordinate care through immediate access to secure patient data. Through EMRs, patient information including health history, medications, laboratory results and more is easily accessible by physicians and health care providers.

This minimizes waste and inefficiency of manual and paper-based processes, maximizes clinical quality at points of decision-making and eliminates most paper used in patient documentation. While paper slows care and creates environments ripe for error, the EMR’s efficiency of delivery helps prevent unnecessary orders and diagnostic tests, reduces medical errors and improves quality of care.

What’s the progress at MemorialCare?

Geidt: Shortly all major MemorialCare facilities will have comprehensive EMRs. That will translate to improvements in safety, clinical outcomes, quality and satisfaction for patients; better efficiency, accuracy and productivity for staff; and engagement and satisfaction among physicians who can easily retrieve complete patient information.

At our campuses using EMRs, less than 4 percent of physician orders are written, thus eliminating almost all transcription errors. Turnaround time for initial physician orders of ‘stat’ medications has been slashed from 41 to 6 minutes. Fewer phone calls to clarify physician orders and increased efficiency mean more time for clinicians at the patient’s bedside. Improved nursing satisfaction means less staff turnover. And a million fewer sheets of paper copied each month makes us a greener health system. The reduced costs associated with EMRs have the potential to save the health care delivery system millions of dollars.

What is occurring nationally?

Geidt: While research shows hospitals adopting EMRs have better patient outcomes and that the majority of Americans want them, less than 10 percent of U.S. hospitals have full EMR systems. That is because of extraordinary purchase, implementation and maintenance costs in the face of reduced reimbursement, plus the labor, facilities, supplies and life-saving equipment costs that are doubling and tripling in price. The ability to improve patient safety and quality, make diagnostic results readily available to clinicians and reduce turnaround time results in EMR investments that are worth every penny. Not only will electronic records make health information more accessible to providers of health care, it also makes health information more accessible to the patients themselves, offering individuals a more organized history of their health, much as Quicken has done for their personal finances.

What progress has been made with physician and outpatient EMRs?

Manker: While doctors and outpatient programs are slow to purchase EMRs due to financial, labor and training costs, government support is likely to speed adoption. MemorialCare is helping affiliated physicians implement an EMR called myMemorialCare in their practices. Other initiatives ensure physicians with or without an EMR system can easily access their patient’s records. Outpatient records are also available to hospital staff during a patient’s admission. Inpatient and outpatient EMRs combine for a true electronic continuum of care.

How can businesses learn more?

Manker: Partner with local hospitals and physicians to see how information technologies impact your employees’ health. Offer programs to educate employees and their families. Promote legislative efforts to create standards for sharing data among health providers. Encourage government, foundations and other groups to financially support health information technology acquisition and implementation.

Geidt: While national economic stimulus is a good start, the road is long and steep as patient technologies move from access for the few to a necessity for all sectors of the health care industry.

Steve Geidt is CEO of Saddleback Memorial Medical Center in Laguna Hills and San Clemente. Marcia Manker is CEO of Orange Coast Memorial Medical Center in Fountain Valley. The facilities are a member of the not-for-profit MemorialCare Health System which also includes Long Beach Memorial Medical Center and Miller Children’s Hospital Long Beach. For additional information on excellence in health care, please visit memorialcare.org.