Every day, I receive pictures, text messages or e-mail from cell phones across the world, yet most U.S.-based hospitals are still relying on information sharing technology thought of as cutting edge in the 1980s.
It’s still hard for me to grasp that less than 1.5 percent of U.S.-based hospitals use a comprehensive electronic health record, according to the March 2009 issue of the New England Journal of Medicine. For decades the Military Health System has relied on its electronic health record to track and share health information data with providers. In 2004, we deployed a comprehensive EHR that now serves 9.6 million beneficiaries.
With President Obama’s support of a nationwide adoption of comprehensive electronic health systems, it’s hard to believe we would not have seen more progress. In fact, the President stated in an address at George Mason University in Fairfax, Va., on Jan. 8, 2009, that “To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America's medical records are computerized.”
As a pioneering institution in the adoption of one of the world’s largest EHRs, the Military Health System has vast institutional knowledge to share. While MHS didn’t have lessons learned from others to model our EHR, we learned through our own trial and error and now hope to share knowledge with other organizations.
Over the next 10 weeks, I hope you will join me as I take you on a journey designed to share the lessons we have learned as the leader of designing and implementing a comprehensive EHR. This topic is very special to me as a military physician who is now charged with improving our system.
This journey of lessons learned with include 10 topics:
Week 1 Choosing the right EHR
Week 2 Test drive, before you buy
Week 3 Hardware matters
Week 4 EHRs should be intuitive
Week 5 The see one, do one, teach one training philosophy
Week 6 Web hosted solutions make sense for speed and redundancy
Week 7 Do not constrain your medical providers with wires
Week 8 Usable and easily computable data makes good health care sense
Week 9 Empower your staff from the beginning to own the new EHR
Week 10 Empower the patients to take responsibility as a partner in their own health care
Choosing the Right EHR
Selecting the right electronic health record choice can be a complex decision for any group or institution. The EHR your organization decides upon must support current work flow in order to best achieve its benefits. It must reflect the way your organization delivers care to patients, from registration to nursing notes, clinical encounters and laboratory results. Before your group or organization purchases a system, take the time to map out how a patient is seen within your practice. Who checks them in? Who starts the subject section of your SOAP (subjective, objective, assessment and plan) note? Will your new EHR support the way you see, treat and document care? Once you understand your work flow, many EHRs can be customized to support the way patients are seen, thereby promoting efficiency and preserving your current business practices.