CMC record system goes electronic

Wed Feb 21 2007 By Jon Tatting

Patients may be noticing a new and improved approach in how they’re receiving care at Cambridge Medical Center.

The approach: an electronic medical record system — a computerized version of the paper system — designed to enhance the safety and quality of a patient’s care.

Allina Hospitals and Clinics and CMC have been busy loading patient charts into the electronic system, which includes medical history relating to allergies, medications, test results as well as contact and insurance information.

While the medical center this month has gone “live” in transitioning its clinic or outpatient areas, CMC is expected to be up to speed with the emergency department and overall hospital by the end of 2008.

“We’ve loaded 10,000 charts (out of 137,000) in the past few months,” said Dr. David Pearson, noting the learning process takes hours of intensive training.

Under the new electronic system, patients will have one record that will follow their care from one clinic to any other Allina clinic, hospital or outpatient facility, which has transitioned to the new system.

The system is also designed to improve the safety and efficiency of a patient’s care as caregivers will have faster access to test results, medical history, medications and prior health conditions. It automatically cross-checks any new prescriptions a caregiver is considering to avoid negative interactions with allergies and current medications.

“This is the biggest change in practicing medicine since medical school, residency,” shared Dr. Pearson of his journey with the new system.

Allina is implementing the biggest integrated electronic system in the country, noted CMC President Dennis Doran.

“It’s a big expense for the betterment of patient care and efficiency. It will be really appreciated by patients,” he added.

Impacts on patients

The new system can retrieve medication information that may be hard for a patient to remember.

Blood orders can be sent electronically without the hassle of paperwork.

Meanwhile, the system will offer a better sense of communication from receptionist to physician.

In light of scheduling, it’s a learning process at Cambridge Medical Center where 400 employees will be impacted by learning the new system. At first, doctors may see less patients in a given day so they can learn as they go.

How it works

During an initial visit, patients will provide their medical history, insurance and contact information so they can be entered into their new electronic medical record. This will save time for future visits as patients will simply verify and update any information.

Information contained in a patient’s medical record may be transferred to another facility outside of Allina or to an Allina facility that has not yet transitioned to the new system.

Doran and CMC staff noted this technology was not available to the medical profession until three years ago, due to security and confidentiality measures.

Privacy held to high standard

Allina and CMC emphasize the privacy of medical information will be more secure than ever, internally and externally, through the new system.

Only medical providers and personnel involved in a patient’s care will have access to his or her record. Another feature monitors who has accessed a patient’s medical information.

‘My Chart’

In about six months, patients will have access to My Chart, a secure Internet tool designed for individual medical records.

Through My Chart, patients can log onto their medical record via a personalized code and password from their home computer. They can view their medications, diagnosis, lab reports and any background information on various health issues or diseases.

Patients can also make doctor appointments online.

With patient permission, instant health-related updates can be shared with other institutions via My Chart. It features a patient’s chart review, progress notes, test results, flowsheets and even graphs showing one’s progress over a certain amount of time.

Article Source: www.isanticountynews.com

Standards rivals’ collaboration could have major impact

By: Joseph Conn / HITS staff writer
Story posted: February 13, 2007 – 10:56 am EDT

The compromise reached between two sometimes rival standards development organizations could have far-reaching implications for the development of a national healthcare information network, experts close to the effort say.

The collaboration, called the Continuity of Care Document, or CCD, is the handiwork of Health Level 7, Ann Arbor, Mich., and ASTM International, Conshohocken, Pa., which jointly announced its release Monday after required formal balloting was completed. Initial development efforts by both organizations was aimed at developing patient care summaries but has since broadened in scope.

The CCD is a melding of HL7’s broader Clinical Document Architecture, or CDA, and the Continuity of Care Record, or CCR, developed by ASTM in collaboration with the Massachusetts Medical Society. Balloting on the much-anticipated CCD began on Dec. 6, 2006, and concluded Jan. 7. It took two ballots to pass muster among HL7 members and other interested parties who reviewed the development, according to Robert Dolin, an Orange County, Calif.-based physician lead for national terminology services for the Kaiser Permanente Medical Group, a member of the HL7 board of directors and the editor-in-chief of CCD for the standards development organization.

Richard Peters, also a physician, is chairman of the ASTM International Committee on Healthcare Informatics and serves as ASTM’s lead in the collaboration on the CCD.

Peters could not be reached for comment by deadline.

“I am the primary editor, and I voted no on it on the first ballot,” Dolin said. “We had enough time so we tightened up all the constraints and the language to use to express the constraints that were a little ambiguous. We went through each section of the CCR and went through it line by line,” he said, making sure it dovetailed with the CCD.

In October 2006, the federally funded Healthcare Information Technology Standards Panel recommended to HHS Secretary Mike Leavitt its first batch of “harmonized” IT standards aimed at facilitating specific healthcare data transmission tasks chosen by HHS. Among those was a recommendation by HITSP that the then-unfinished CCD be adopted for the exchange of certain clinical information, including patient demographics, medications and allergies.

HITSP Chairman John Halamka, the physician chief information officer of Harvard Medical School, in an e-mail called the successful CCD ballot “a very significant development for healthcare IT” and “a milestone in the standards world.”

“HL7 and ASTM worked together seamlessly to incorporate the best of their standards into a work product that will now form the basis of many HITSP Interoperability Specifications,” Halamka said. “CCD was included in the HITSP interoperability specifications submitted to Secretary Leavitt last October. We’ll ensure any updates to CCD are included in our next release of interoperability specifications which will be voted on in May.

Work by ASTM on the electronic CCR flowed out of an initial effort by physicians in Massachusetts to develop a standard, paper-based discharge summary for patients leaving the hospital bound for nursing homes.

Dolin said a similar interest by HL7 members to develop a standard for patient summaries led HL7 to come up with on its own Care Record Summary, or CRS. But the parallel development work of ASTM on the CCR and HL7 on its CRS led to strained relations between adherents of the two standards—what Dolin diplomatically described as “all this politics going on between HL7 and ASTM.” Cooler heads apparently have prevailed and with the collaboration leading to the successful balloting, “CRS is now sunseted by CCD,” Dolin said.

A major event at the IT trade show, Toward the Electronic Patient Record, last May in Dallas, was a demonstration of the CCR by more than a dozen vendors of electronic medical-records systems. At the time, most of the participating vendors could export documents in the CCR format and at least one vendor could import a CCR document and seamlessly place discrete data elements from the record in the fields of the receiving vendor’s EMR.

The demonstration showed the potential of peer-to-peer communication between physicians with different EMR systems.

Peter Waegemann, chief executive officer of the Medical Records Institute, sponsor of the show, said development of the compromise CCD “is really a win-win situation.”

Vendors and users of large IT “legacy” systems that are backers of HL7’s Clinical Document Architecture will gain the most benefit from the CCD because they will be able to use the CCR format in their systems, Waegemann said. But the collaboration with HL7 on the CCD further establishes the CCR, he said.

“Both have a community and both are good for the doctors and everyone else,” Waegemann said.

The American Academy of Family Physician’s Center for Health Information Technology operates an online list of EMR and personal health record system vendors that have committed to using ASTM’s CCR. The list, currently with 31 vendors, also includes the status of their CCR incorporation efforts.