Health care providers are changing the way they do business in Northern Arizona to meet laws requiring that all medical records are available electronically. Congress passed the 2009 American Recovery and Reinvestment Act Pathway for Meaningful Use, which included requirements and incentives for hospitals and physicians in private practice to implement certified electronic medical records (EMR) technology by 2015. Local medical facilities are starting now.
Northern Arizona Healthcare, the parent organization of Flagstaff Medical Center, Verde Valley Medical Center and Verde Valley Medical Center-Sedona just completed the first stage of the Meaningful Use requirements to implement certified EMR.
Marilynn Black, vice president of systems integration at Northern Arizona Healthcare explained, “In essence, instead of using papers, clinicians need to record information online via text or voice recording.”
According to Black, “The conversion is pretty massive. It is changing the workflow of every clinician that documents care.” Northern Arizona Healthcare went live with electronic medical records in 2004, prior to the American Recovery and Accountability Act. However, 18 months ago, consolidation to one EMR system began. Requirements for the single system included: minimal clicks for ease of use, the ability to augment with numerous software systems, and communication in the same language through all departments.
“Each specialist has different needs for online recording,” said Black. “There was a lot of listening and understanding going on. This is a lot of change, and rapid change.” One of the goals of Meaningful Use is to provide patients with greater electronic access to their health information. Medical records are provided in the requester’s preferred mode that includes hard copy, CD, thumb drive or personal portal.
“When you or a family member or loved one gets care, you see more than one care provider. We are allowing information to be available to all providers. Before, information was very siloed. Now information will be available to the right provider at the right time regardless of geographical location,” Black said.
Kim McCasland, practice administrator at Northwoods Medical Associates, agrees. “Implementation of patient portals makes data more transparent so you can take your information across state lines.”
McCasland is slowly rolling out the functionality of patient access on their EMR system. “We have thousands of patients and I don’t want my clinicians to be flooded with requests. Last Tuesday we opened the appointment request function, and on Wednesday we already had two requests for appointments.”
Randall Scott, MD has been submitting electronic data from exams and patient interviews since 2004. His learning curve for switching from paper to computer was rather short. “For the first couple of days, I felt uncomfortable because I was used to having a big fat pad of paper charts on my lap. But I do not think it took a whole week to get used to the electronic charts, which are much better. I don’t have the thick charts come flying off my lap anymore,” the Northwoods Medical Associates doctor laughed. “Some patients were so complicated that I had five or six volumes of charts. When I switched to electronic back then, I intuitively knew that this was coming.”
The Recovery Act specifies three components of Meaningful Use: Use of certified electronic health records in a meaningful manner such as in ePrescribing, use of certified EMR technology for electronic exchange of health information to improve quality of health care and use of certified EMR technology to submit clinical quality measures.
According to the U.S. Department of Health and Human Services, “Simply put, ‘meaningful use’ means providers need to show they’re using certified [EMR] technology in ways that can be measured significantly in quality and in quantity.” Meaningful use of EMR includes capturing and sharing data results in improved clinical processes, which, in turn, makes for improved health outcomes.
Furthermore, electronic medical records enable technology that allows hospitals and physician practices to pursue more robust quality improvement programs than is possible with paper-based records.
Black believes that the new processes will improve results. “This is definitely better for health outcomes. We can aggregate data by conditions to prove that we can improve in areas like diabetic care, which a community assessment showed is a need in our community. We’ll be able to prove that our outcomes are better.”
Black points out that patients still control access to their own information. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects the privacy of individually identifiable health information. “We adhere to ‘Nothing about me, without me.’ Patients have a choice to opt in or opt out. They have the right to state yes or no, bottom line.”
“Electronic Medical record systems are secure and encrypted,” added Scott. “It is almost like a bank – patients have to use a PIN number and no one else can accept their records.”
“This is evolution in progress we all have to get used to it takes time to learn it, process it, and use it in an effective manner,” concluded Dr. Scott. FBN