EDITOR’S NOTE: Hospitals like Gothenburg Memorial Hospital are making the switch from paper to electronic health records to help reduce human error and improve workflow efficiency. Hard copies of patient information, lab results and prescriptions can easily be misplaced or misfiled, but with electronic health records, doctors can access an entire patient record with a single click of a mouse. For increased patient care & safety, nurses are able to scan a patient’s ID wristband to learn the correct dosage and time to dispense medication, instead of looking the information up on a patient chart.
Tinna Therrien has a foot in two worlds—one in information technology and the other in patient care.
Therrien, Gothenburg Memorial Hospital’s clinical informatics director and chief information officer, was hired to make the transition from paper to electronic records and design effective workflow in various departments.
The hospital will go live with the new system on March 9.
As an informatics nurse, Therrien implemented electronic records at the same hospital in Vermont where GMH chief executive officer Mick Brant worked.
Clinical informatics, she said, is a marriage between nurse, doctor or other health-care providers and information technology to improve patient care.
Quality patient care is critical, Therrien said.
“We’re changing the way we work so visits are seamless,” she explained. “The easier data is to access, the better the patient will be served.”
Instead of doctor-centered scenarios, Therrien said the change to electronic records and different workflows will create a patient-centered system with better outcomes.
“Electronic records enable safety, quality and efficiency that connects health care in a single record,” she explained, noting that doctor visits, lab results, drug needs and more will be included in a record that can only be accessed by patients and their doctors.
At a computerized workstation on wheels, Therrien showed a wand that scans bar codes on medicine so patients receive appropriate drugs.
Scanning patient identification bracelets reveals the correct dosage and time to dispense medicine.
“It’s a closed-loop system,” she said.
Vital signs are directly uploaded into the patient’s record that can also include information from fetal monitors and other obstetric information.
During clinic visits, she said nurses will put patient information into mobile laptops rather than on paper charts.
Results such as from X-rays will be electronically recorded and can accessed by doctors and patients.
“The doctor can pull up an X-ray on the computer to provide a visual for the patient,” she said, noting that patient portals are secure.
The company providing software and technical expertise is Cerner Corporation, based in Kansas City, MO.
Therrien said GMH medical staff is learning Cerner’s system, which is in place, and testing it.
They’ve walked through several patient scenarios to insure that the system is accurate and complete.
Decisions about how care is provided are made through the best evidence-based practices, the clinical informatics director said.
For example, doctor teams worked closely with hospitals in Kearney and Lincoln to match care protocols which allows for a more flawless continuation of care once patients are transferred.
“So we do it right the first time,” Therrien said.
Likewise, nurses researched, built and tested a system to insure that patients are appropriately screened and given the right level of care.
“The whole facility is dreaming big,” she said. “Electronic medical records is just one piece as we evolve into a standard of care of excellence that is quality and cost efficient.”
As an illustration, Therrien pointed out that not only is GMH implementing electronic health care records but also an integrated financial, human resources, case management and pharmaceutical system that includes a 24-hour pharmaceutical reviewer.
She noted that Cerner is the central integration point for all these departments.
Because all departments and employees worked side by side during the work week and on some weekends and holidays to transition to electronic records, Therrien said they’ve created a cultural environment in which barriers have been broken down.
“That’s my favorite part, watching people bond,” she said. “Most want to bond but there’s not a space for them to do it.”
The biggest challenge in changing to electronic records has been making sure that patient care didn’t suffer, Therrien said.
Perhaps the biggest benefit to electronic records is a decrease in human error.
“With integrated systems, you have the right data, the right time and the right person,” she said, noting that paper records often involved time searching for information.
Therrien said electronic records will be at the fingertips of patients and their care givers.
In the future, Therrien said GMH hopes to link electronic records with Hilltop Care Center and Stone Hearth Estates.
She added that records on paper are still available if a person wants them that way.