Adopting electronic medical record (EMR) software allowed doctors at the Clara Maass Medical Center to access patient files over any Internet connection. As this case study shows, adopting EMRs made it easier for physicians to share test results, medication histories and other key information.
Although the IT department at Clara Maass Medical Center is responsible for overseeing, maintaining and enhancing the hospital's computing infrastructure, even the most perfectly suited electronic medical record (EMR) software would waste hospital resources if doctors were reluctant to adopt the technology.
For physicians to adopt EMR software, the system would have to provide access to all patient tests, X-rays and other scans; generate letters to referring physicians; and be easy to use, said Donald Lutz, the medical center's CIO. Physicians also wanted the ability to create e-prescriptions that could be sent immediately to patients' preferred pharmacies, he said.
In the past, doctors accessed patient information using Siemens Healthcare's eHealth Solution. This system was accessible only at Clara Maass or the sites of fellow Saint Barnabas Health Care System members. Physicians could not check patient records outside hospital environs or generate e-prescriptions, Lutz said.
After researching its options, Clara Maass winnowed its list to three providers of EMR software. "We actually had criteria -- three pages -- that went into what the health care system has, going down as far as disaster recovery, HIPAA[Health Insurance Portability and Accountability Act] compliance and security," Lutz said. "We also considered how long they'd been around, since EMRs are coming and going. And we looked at each company's installed base."
Lutz visited facilities on both U.S. coasts before selecting Axolotl's Elysium Exchange as Clara Maass' software for EMR.
An improved prognosis for EMR
Due to the depth of negotiations, it took almost a year to negotiate a contract with Axolotl, Lutz said. After that, however, pre-implementation planning helped Clara Maass get Elysium Exchange up and running in 90 days. "We had one of the quickest rollouts in Axolotl's history," he said. "Everybody jumped through hoops to make it happen."
With Elysium Exchange, physicians can manage patients' incoming clinical information, such as lab reports, medication histories and allergies. Users also can order lab tests and radiology images, and send clinical messages to colleagues and referring doctors. (All records are transferred in accordance with HIPAA requirements to ensure patient confidentiality.) Doctors then can forward pertinent information to their own EMR or Axolotl EMR Lite implementation for easy access and data consolidation.
Because of the EMR system's Web-based interface, doctors can view patient data anywhere. This helped one doctor, covering for a colleague, who received an after-hours call. The doctor logged into EMR Lite, read the patient's file and answered the questions. "As long as you have access to the Internet, you can go anywhere with EMR Lite," Lutz noted.
One challenge for Lutz has been getting the doctors' office staffs to participate in the hospital's two-hour training sessions on its software for EMR. "I don't care if it's 7 a.m. or 7 p.m. I'll be there," for training, he said. "We'll go back as many times as they want. . . . We bend over backwards for them."
Future plans for EMR
Although Clara Maass was the first hospital in the Saint Barnabas system to adopt Axolotl's EMR software, it probably won't be the last. IT professionals, doctors and administrators at sister facilities are monitoring Clara Maass' progress -- and a good prognosis could spur additional implementations, Lutz said.
Because of the EMR system's Web-based interface, doctors can view patient data anywhere.
"The system is looking at expanding it to other affiliates," Lutz explained. "Hopefully there will be more doctors signed up."
In addition, the hospital is negotiating with Axolotl over the price of e-prescribing, because several doctors have requested this capability, Lutz said. "That's one of the things doctors told me they'd like to see. If it's within reason, I'm sure we'll do it," he said.
According to a recent New England Journal of Medicine survey, fewer than 10% of U.S. hospitals have software for EMR. Adoption is expected to increase in the future, spurred largely by the government's EMR push in the American Recovery and Reinvestment Act. But Clara Maass moved ahead now, to best support its physicians and nurses, Lutz said.
"We looked at what we had, where we wanted to go, and how we could give doctors easy access and make it easy for them to sign onto this," Lutz said. "More and more hospitals are doing this, and we wanted to stay on top of technology."