Andrew Burchett, D.O.’03, admits with a laugh that when he agreed to become his health system’s medical information officer, he didn’t know what he was getting himself into. He took on the role in 2007, when the Avera health system – which provides services in South Dakota and surrounding states – launched an update of its Meditech software system; the previous system had been implemented 14 years earlier, eons in technology years.
“There are 50,000 patient charts in my clinic alone,” says Burchett, who has a full-time family medical practice at Avera McGreevy Clinic and also serves as chair of family medicine at Avera McKennan Hospital, both in Sioux Falls, SD. “Our goal is for all our systems to talk to each other, but we’re not there yet.”
Avera is not alone in that regard. According to a recent report in Business Week, just 10 percent of U.S. health care facilities used electronic health records in 2009. The federal government wants more than half of all facilities to use them by 2014, and it provided $36 billion in last year’s stimulus legislation to help them do so. Like many physicians, Burchett is convinced EHR s won’t fulfill one of their purported promises: cutting health care costs.
“The cost of implementation means savings can’t be part of the equation for a long time,” he says, noting that Avera McKennan and its clinics had to spend significantly more than the $40 million initially budgeted for the project – and that was just for an upgraded system. “Improved patient safety, quality and efficiency are what drive us.”
That’s where technology makes a difference. In recent years, Avera has developed several innovative technology applications, Avera eCare ™, that connect specialty care physicians and pharmacists to health care workers and patients in rural areas. Through two-way video and other equipment, 24 hours a day, seven days a week, Avera staff can view a patient in a rural facility miles away, guide its care providers, view the patient’s records and radiographic images, arrange for transportation to a bigger facility if needed, and review and approve prescriptions. eCare also provides patients with monitors set with individualized health instruction and follow-up care in their homes.
In addition to supporting rural practitioners, these services allow many patients to get care in their own communities. More important, they save lives. Since 2005, Avera’s electronic intensive care unit services alone have enabled nearly 400 individuals, who initially were not predicted to survive, to leave hospital care alive.
“That’s how technology can save lives and reduce costs,” Burchett says.
Tech Transition Tips
Andrew Burchett shares these lessons on implementing electronic health records:
- Take the time to research system and software vendors. Despite the urgency in implementing EHRs, choosing the best system for an organization is a critical first step in reducing snafus down the road.
- Recruit doctors and information technology staff who understand each other to lead the process. Burchett serves as a liaison to help both sides understand what is needed, what is possible and what system changes should be made.
- Plan to customize. Record systems offer a variety of options that should be selected to match the organization’s processes and practices.
- Get everyone on board. “Some physicians understandably ask, ‘I’ve always used paper records; why do I have to change?’” Burchett says. “Showing them improvements in patient safety and examples of ways we can connect our specialists to rural areas gives them compelling reasons.”
- Invest the money – a lot of it. In addition to the costs of equipment and software are costs of training staff, transitioning from paper to electronic records and providing ongoing support.
A new Watermark Medical device enables physicians to test patients for obstructive sleep apnea at home. Patients don a cap with built-in sensors that monitor airflow, effort breathing, oxygen saturation, heartbeat and several other biometric measures, which – after one or two nights’ sleep – are then transferred to computers for analysis and diagnosis by sleep-medicine professionals.
At the new Roy and Patricia Disney Family Cancer Center in Burbank, CA, patients can use ambient technology to control the lighting, sounds, music and video in their rooms to create a calming environment as they undergo radiation treatments. The center also provides centuries-old Eastern-style therapies such as herbal medications, yoga and meditation to treat the body, mind and spirit.