Media
MEDIA
Rural Hospitals Make LSU Connection
by TED GRIGGS
Louisiana Medical News – November 2007
A $13 million state program will allow physicians at the Louisiana State University Health Science Center in Shreveport to consult with their counterparts at rural facilities in North Louisiana.
The project will also help poor residents avoid unnecessary trips to the charity hospital.
From my perspective, and most peoples perspective, its a huge deal to keep those rural citizens at home, said Jamie Welch, chief information officer of the Louisiana Rural Hospital Coalition. That way they dont face the sometimes several-hour drive to Shreveport dealing with poor road conditions and the expenses of driving.
Most low-income people dont have the kind of vehicle that can make a long trip, Welch said. Even with a reliable car, a lot of people cant afford the gas.
During the first year of the five year project, the LSU-run facility in Shreveport will get a little more than $2 million to upgrade or add equipment for telemedicine, Welch said. The
telemedicine technology will be available to all 24 of the rural hospitals in North Louisiana.
Seven of those hospitals will be part of a pilot project, the North Louisiana LSU Health Science Center/Rural Hospital Medical Home Network, that will help the hospitals with electronic medical records, financial systems and clinical information systems.
Dr. John McDonald, chancellor of LSU Health Science Center in Shreveport (and the person Welch credited for
coming up with the idea for the new system), said a seamless electronic medical system connecting the LSU hospitals in Shreveport, Monroe and Pineville to the rural hospitals in North Louisiana would do a lot to improve patient care.
My thought was if a patient came to their (rural) hospital, with, say, substantial pneumonia or out-of control-diabetes, they could consult with someone here who was an expert in that, McDonald said.
The doctors could then decide together on the best treatment, and the patient could stay in his community, Mc-
Donald said. Specialists at the LSU-run hospitals could continue monitoring the patients through telemedicine.
In rural communities, doctors dont always have the option of consulting a specialist or a physician who can say whether the patient can be treated at the rural hospital or needs to be sent to Shreveport, Welch said. As a result, most cases get sent to Shreveport. McDonald said he did not know how many unnecessary referrals are made to Shreveport, but the number is substantial.
The new system will allow specialists at LSU to see the patient, check his records for information and even use cameras to examine his throat.
The technology is sitting out there waiting on us, McDonald said.
The Shreveport hospital has been running at 100 percent capacity since a week after Hurricane Katrina, Welch said. The program will provide a huge relief for the Shreveport facility by enabling it to handle the patient load in different ways.
The seven rural hospitals in the programs first year are Bunkie General Hospital in Bunkie; DeSoto Regional Hospital in Mansfield; Hardtner Medical Center in Olla; Homer Memorial Hospital in Homer; LaSalle General Hospital in Jena; Richland Parish Hospital in Delhi and Union General Hospital in Farmerville.
This will enable us to move into the 21st century without financially strapping the hospital, said Linda Deville,
Bunkie Generals chief executive officer. Moving from paper to digital records is expensive, and it would have been hard for rural hospitals to make the switch without help, she said.
But the new systems should help the hospitals improve efficiency and lower costs.
Welch said the rural hospitals are in the process of taking bids or evaluating the bids on the systems. The systems will belong to each hospital, but the coalition is encouraging its members to negotiate a group purchasing deal, she said. Welch said the technology providers for small hospitals differ from those that service the larger facilities. There may be only five players in the small hospital market, she said. None of the rural hospitals are getting 50 bids for their systems.
In the first year, all 24 hospitals will get a point-to-point T1 line to the Shreveport facility. The hospitals will also get a full-blown telemedicine/distance-learning system that has all the bells and whistles, such as a digital stethoscope and a variety of other attachments, Welch said.
Welch said the hospitals are now discussing whether to use projection screens or 42-inch plasma monitors. The hospitals choices will depend on how much room they have available, she said.
The plan is to add seven hospitals to the program each year until all 24 are connected to LSU, she said. The systems have to be able to communicate with LSU, but the technology will also allow the hospitals to communicate with each other.
For example, groups of physicians from the rural hospitals will be able to work together more easily to decide the best way to treat community-related pneumonia, McDonald said. The physicians can agree on the most appropriate medication for the patient, as well as the course of treatment if there are complications.
These sorts of cooperative efforts can help hospitals save money on patient care and prescription drugs, McDonald said. In addition, common access to imaging studies, such as X-rays and CT scans, and lab work would allow the LSU hospitals to avoid duplicating the work done by the rural hospitals.
Springhill Medical Center EMR Transition is Front Page News
More doctors go digital with patients’ records
November 14, 2007
By Mary Jimenez
The Shreveport Times
maryjimenez@gannett.com
Monett Gavin comes to work to sit at a desk and scan medical records into a computer system eight hours a day, five days a week.
The painstakingly mind-numbing job one day will pay off when all patients’ files at Springhill Medical Center will be accessible with a click of a button.
It’s not the most glamorous job, but would no doubt get a gold star from Louisiana officials.
For once, the state is on the forefront of a movement.
In a push by government to have most doctors using electronic health records by 2014, Louisiana is one of 12 states that have implemented health information technology for Medicaid beneficiaries, according to an August report by the Health and Human Services Department’s inspector general’s office.
Electronic health records are what you might think they are, but a little more.
An electronic medical record is a health record in digital format. The medical records are just one aspect of EHRs, which could also include a variety of health related information from a variety of sources.
In order to convert older paper records to an EMR a digital scanner is used. Once in digital format EHRs are usually accessed on a computer, often over a network.
Springhill Medical Center is one of many health-care providers throughout Louisiana that are making the change.
“It’s a proactive move from a small rural facility,” said John Rainey, CEO of Springhill Medical, who stepped into his job in August a month after the north Webster hospital began its big records transition.
“Yes, there was a financial burden. And it’s kind of a tedious process right now,” Rainey said. “But you have to look to the end for the real benefit.”
There are many benefits to spending an estimated $30,000 to $50,000 per licensed user (depending on software bells and whistles) and going through the estimated six months to a year transition time, he said.
Springhill Medical has invested more than $150,000 in the Misys Healthcare System, which has five physicians using it.
“There’s the legibility of documents, more accuracy, you won’t have lost charts, it will be readily assessable and it will be more secure,” Rainey said. “In a paper record, you don’t know who’s looked at it. With an electronic record, it tracks everyone who looks at the record.”
Freed storage space and a recruitment tool are also benefits, he said.
Rainey believes patients will be the biggest beneficiaries.
“The charts will have easy access to critical information, allergies and medications at your fingertips. One of the reasons we decided to do it was because it’s tied to a quality aspect of health care.”
Many physicians are living the benefit of having trudged through the transition from paper to electronic.
Shreveport internist Wen Liu transitioned to electronic health records in 2002; kicking and screaming, he admits.
“I was dragged into it by my previous partner,” said Liu, who’s found it’s been well worth the effort. “This is the best thing that’s happened to my practice.”
Pointing to a small battery-operated wireless laptop, he demonstrates the ease in operations. Liu makes a few taps on his screen.
A request for a prescription refill for a patient had arrived via e-mail. Liu checked the chart, OK’d the request and pushed the print button for the prescription.
“This will print in the next room. Now we’re working on setting up e-prescribing” (automatically sending the request by e-mail to the pharmacist.)
At a glance, Liu’s system shows him which patient charts are open and why, laboratory reports that haven’t been looked at or that have abnormal results, medications the patient is taking and when the last time they were prescribed and several other safety measure alarms and reminders put in with the use of color-coded flags and messages.
Liu’s next software upgrade will give him a list of the least-expensive drug choices on the market when he writes a prescription.
“All those features, you aren’t able to obtain from a paper chart,” said Liu, who finds the patient’s privacy is even more protected under his system. “There are levels of access. It’s password protected.”
Down time is another startup worry that Liu says has not been a factor.
“It’s just like your Internet at home. How often is that down? Very rarely,” Liu said.
If the building loses power, workers have three hours of generator power to work from.
Storing files is also more secure. They are stored daily and twice more off site.
“It’s an automatic save,” Liu said.
It’s unclear how many Louisiana physician offices, clinics and hospitals have made the push to electronic records, Berg said. But in a survey conducted this year by the Louisiana State Medical Society, 36 percent of physicians indicated they should be paperless within the next three years.
Part of the barrier to the change has not only been the temporary disruption to business, but also cost.
The federal government is stepping in to help with the latter, both in the way of grants for startups and money back to physicians if they use electronic health records.
In 2008, the Medicare program will pay bonuses to doctors and other health-care providers for using electronic health records and e-prescribing.
Use of the two technologies are among 119 quality measures the Centers for Medicare and Medicaid Services lists in an official notice of its payment rules for the coming year.
That represents a very important change in health care, said Jeanie Berg, of Louisiana Health Care Review Inc. Berg is an adviser to providers making the transition to EHRs. “The health-care environment is shifting to one focused on quality care and getting paid for that. That’s good.”
The federal government’s push is to eventually get all health-care providers using compatible systems that can talk with each other, offering a more global sharing of files.
We’re a ways from that, Berg said, but the government has already imposed national standards for health-care providers when choosing a software vendor.
“In the future, people can have their own patient records anywhere they go, a Web-based tool,” she said. “But even now, if your health-care provider is using electronic records, you can request a copy on CD or flash drive and take it with you.”
Springhill Medical is several months from feeling the ease of electronic health records that Liu’s office has, but staff members already are embracing the new technology.
Registered Nurse LaQuita Fields, who has worked at Springhill Medical for 27 years, had no problem letting go of her charts in place of a notebook. “Electronic records are great. Everything is right at your fingertip. I can scan in pictures from an X-ray or other image and share it with the patient and make it bigger for them.”
Even Gavin can see the future is bright.
There have been days when she’s searched hours for a chart. “Now I just put in a patient’s name and pull it right up.”
RELATED LINKS
Electronic health records explained: www.ehrtoday.org
Springhill Medical Center: www.smccare.com
American Hospital Association’s 2007 report about hospital use of HIT is available at: www.aha.org
Medicare doctors can get bonuses for using electronic health records and e-prescribing in 2008: www.govhealthit.com