EHR implementation held after Minn. bridge collapse

CAMBRIDGE, Mass. -- In the early days of summer 2007, Hennepin County Medical Center in Minneapolis completed its Epic Systems Inc. electronic health record (EHR) implementation. A month later and a mile away, Bridge 9340 over the Mississippi River collapsed, injuring 145 people and killing 13.

At the World Congress 3rd Annual Leadership Summit on mHealth, HCMC CMIO Kevin L. Larsen, M.D. shared his account of how the staffers -- who had just gotten accustomed to the EHR workflow -- quickly ditched the paper backup system for which the disaster response plan called. Turns out, electronic records were a faster, more efficient way to handle a patient surge, even though it was such a recent EHR implementation.

Let us know what you think about the video; email Don Fluckinger, Features Writer.

Read the full transcript from this video below:  EHR implementation held after Minn. bridge collapse

Kevin Larsen: We've been live for over five years. We're live with all of our clinicians; we're live with all of our sites secure. That medical records slide, that doesn't exist for us anymore. We have sort of a residual chart that lives in the basement. We're busy trying to remodel that whole area and figuring out when we can destroy the last of our paper files.

We have ten-plus years of stored data that is stored in interoperable data format and is instantly and easily accessible. Those include demographics, includes historical medication, labs, patient's history for example. We've integrated more than a hundred systems into this a single platform viewer tool, and these include all the features that you hear about for Meaningful Use. We're lucky to be interoperable with over ten EHRs of other health systems in our state.

That's over 70% of Minnesotans, so as a primary care physician in my clinic I can be talking to a patient and they'll say, "Yeah, I just was in the ER, at the hospital across the state" and it's a competitor for us. I can log into the computer, get their permission and within seconds have downloaded the ER visit, the radiology results that that patient had, their notes, any medications they were prescribed, and we can have a discussion right then and there in my room.

We also have a live data exchange from our state physician registry. We get medication history from our peers through e-prescribing, and we also get peer insurance formularies. And then, we're inter-connected with 20 state radiology systems. I think there isn't a lot of discussion about the kind of image movement, but that's really been a huge win for us that we can move images back and forth, again, over the web.

So, this is sort of the view from our place. The electronic medical record has really been the central core, our vendor is Epic and we then interconnect all of these other systems across our campus and across our state into this central core. We worked hard to make sure that the data is in a standardized format so that we can leverage that data across these multiple systems. 

This is how you might know us for those of you that don't remember Hennepin County Medical Center; we're the hospital about a mile away from the Minneapolis Bridge collapse. This bridge collapsed about a month after we were fully live with our electronic medical records. And so we decided - we had planned that in time of a major disaster we were going to move to paper because that was really the only way we could imagine dealing with the disaster. We started bringing patients from the bridge collapse to our emergency room, and they did the first two on paper and everybody got so frustrated they pulled out the computers and they started doing all of the multitronic casualty on the computers because it was much more effective and efficient than to pull out our old paper mass-casualty system.

This was a month after we'd been live, so we had early adoption and actually aggressive adoption. We found it much easier to actually track those patients. In fact, we could at any time tell where they were in our hospital because the other hospitals in the state were in a similar place. We could really -- live -- know where patients were at any of the number of hospitals. It was part of the reason that this worked so smoothly.

One of the things I didn't really get into here, but we actually deploy mobile devices to all of our ambulance services so they're fully live on their own electronic medical record in our pre-hospital and ambulance systems and interconnected with the central server. So, we can actually exchange data pre-hospital to hospital as well.

Another picture of our bridge collapse. We were lucky, that whole bus load of kids though ended up in our hospital in the ER all at one time.

So, we're actually ready to submit for meaningful use. We were planning to do it this month, but if you've been following the Minnesota news, we had a state government shut down. It turns out we're submitting for Medicaid which is administered by the state, and so we have to actually wait for the state government to turn its lights back on and get their submission acceptance ready. We're also ready to submit for over two thirds of our eligible providers, and the rest that we have to submit for we're really actually quite close with almost all of them. They're all e-prescribing, they're keeping promises, they're doing the things they need to do.

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