Healthcare Forum Benefits of Integrated Medical Records A Case Study, September 24, 2014 Meeting Host: Meeting Co-Sponsor: Presentation / Panel moderator: Jerry Dickerson, PMP 1
Introductions Project Manager and Panel Moderator Jerry Dickerson, PMP, Project Manager, CMC-Corporate IS Panelists Dr. Hagop Afarian, MD, CMC-Chief Medical Informatics Officer, ED Physician, Tamie Talley, Cardiology Computer Systems Specialist, CRMC-Cardiology Toni Taylor, RT, Supervisor of Diagnostic Medical Imaging, FHSH Brandon Bedsted, Clinical Systems Group Manager, CMC-Corporate IS 2
Today s Presentation A primer on Healthcare Information Technology (IT) What is an Electronic Medical Record (EMR) What makes an EMR Integrated? A Sample Integrated EMR Panel Discussion 3
A primer on Healthcare IT: We ve come a long way 1950 s 2010 s 4
Healthcare IT diversifies Rich Data Small Form Factor Mobile 5
Healthcare IT impact on EMRs Before Healthcare IT Medical Records After Healthcare IT Electronic Medical Records Film Imaging Patient Archive and Communication System (PACS) 6
What is an Electronic Medical Record? An Electronic Medical Record is a digital version of a paper chart that contains all of a patient s medical history from one practice. An EMR is mostly used by providers for diagnosis and treatment. Benefits of Electronic Medical Records An EMR is more beneficial than paper records because it allows providers to: Track data over time Identify patients who are due for preventive visits and screenings Monitor how patients measure up to certain parameters, such as vaccinations and blood pressure readings Improve overall quality of care in a practice Source: HealthIT.gov 7
How do EMRs work? Hospitals use EMR s from a patients arrival in the ED or In-patient care area through discharge. Contain patient demographic data to include allergies, insurance information, etc. Throughout care, providers input clinical data, medications, treatment, progress notes, etc. Clinics also use EMR s to track a patients care in the Out-patient care setting Contain ongoing patient care information used to monitor patient conditions between visits Used to schedule and track a specific care episode or treatment In either in-patient or out-patient use case, EMR s are essential to permit a provider to view past patient visits/stays/outcomes Due to federal legislation (ARRA, ACA, etc.), making EMR s meaningfully useful is forcing hospitals and clinics to share EMR information *electronically* CMC is part of the Central California Health Information Exchange which facilitates EMR data between local hospital and clinic based providers 8
Who makes EMR s? Many EMR vendors exist ranging in size from small specialty EMRs to large enterprise EMR s The biggest of the enterprise EMR software vendors are Meditech, Cerner, and Epic. In our local Fresno/Clovis area Children s Hospital of Central California uses Meditech St Agnes Medical Center uses Cerner Kaiser and Community Medical Center (CMC) use Epic Also in this market are Modality Vendors, those providing large capital equipment producing graphically rich diagnostic imaging, data and information. These systems are categorically called PACS Patient Archival and Communication Systems Philips, GE, and Siemens amongst the biggest of the PACS vendors Enterprise PACS Systems typically link modality imaging back to the Enterprise EMR At CMC, we use Fuji R-PACS for Radiology Imaging, Agfa C-PACS for Cardiology Imaging, and many smaller vendors for other specialty modalities R-PACS, C-PACS and some other (but not all) modality PACS systems are integrated back to the Epic EMR at CMC 9
A Sample Integration Project Epic EMR Epic is where a MD orders an ECG Study Agfa ECG Management Agfa is where the ECG Study is stored Integration permits the ECG Order to link To the correct ECG 10
Why do we need an Integrated EMR? Key to EMR clinical effectiveness is the ability to seamless transfer data and view modality imaging between these multiple systems using integration or interface engine technology EMR Integration is the ability of two separate systems storing patient medical record information to share information based on a common Enterprise Master Patient Index (EMPI) Integration permits having for a specific patient just the right clinical information at just the right time without difficulty in finding it The MOST difficult Healthcare IT projects involve Integration. These projects require: Careful planning and analysis of what is needed Significant coding effort thorough system validation testing consistent monitoring of error queues and corrections as those errors occur Today s panelists will discuss the importance and challenge of integrating CMC s Epic and Agfa C-PACS and specifically Heartstation based Electrocardiagrams (ECG or EKG) 11
Panel Discussion Panelists Dr. Hagop Afarian, MD, CMC-Chief Medical Informatics Officer, ED Physician, Tamie Talley, Cardiology Computer Systems Specialist, CRMC-Cardiology Ron Delarm, RN, Supervisor of Diagnostic Medical Imaging, FHSH Toni Taylor, RN, Diagnostic Medical Imaging, FHSH Brandon Bedsted, Clinical Systems Group Manager, CMC-Corporate IS Question 1: What is the benefit of Integrated EMRs? Question 2: What is the challenge of Integrated EMRs? 12
Panel Discussion Panelists Dr. Hagop Afarian, MD, CMC-Chief Medical Informatics Officer, ED Physician, Tamie Talley, Cardiology Computer Systems Specialist, CRMC-Cardiology Ron Delarm, RN, Supervisor of Diagnostic Medical Imaging, FHSH Toni Taylor, RN, Diagnostic Medical Imaging, FHSH Brandon Bedsted, Clinical Systems Group Manager, CMC-Corporate IS Question 3: What went well on this particular Integrated EMR project? Question 4: What could have gone better? 13
Panel Discussion Panelists Dr. Hagop Afarian, MD, CMC-Chief Medical Informatics Officer, ED Physician, Tamie Talley, Cardiology Computer Systems Specialist, CRMC-Cardiology Ron Delarm, RN, Supervisor of Diagnostic Medical Imaging, FHSH Toni Taylor, RN, Diagnostic Medical Imaging, FHSH Brandon Bedsted, Clinical Systems Group Manager, CMC-Corporate IS Last Question: Where do you envision Integrated EMR s are going? 14
Other Questions for our Panelists? Panelists Dr. Hagop Afarian, MD, CMC-Chief Medical Informatics Officer, ED Physician, Tamie Talley, Cardiology Computer Systems Specialist, CRMC-Cardiology Ron Delarm, RN, Supervisor of Diagnostic Medical Imaging, FHSH Toni Taylor, RN, Diagnostic Medical Imaging, FHSH Brandon Bedsted, Clinical Systems Group Manager, CMC-Corporate IS 15
Special Thanks to our Meeting Host and Co-Sponsor! 16