MSU HEALTHTEAM CLINICS CONVERT TO ELECTRONIC MEDICAL RECORDS

11/21/2002

EAST LANSING, Mich. - The more than 30 clinics that make up the Michigan State University HealthTeam are converting from the use of traditional paper-based medical records to a new electronic medical record (EMR) system, a major undertaking that promises to improve health care quality for the thousands of patients who receive care at these clinics.

"Health care delivery systems that continue to rely on paper charts for recording and communicating patient information cannot ensure that high-quality care is available in a timely, safe and efficient manner," said Michael Zaroukian, MSU associate professor of medicine and medical director of the EMR implementation project. "Only computer-based patient record systems can meet these complex information demands.

"We intend to use the EMR to greatly improve quality and dramatically decrease inefficiency, waste, medical errors and omissions of care," Zaroukian said. "We will also be working to develop even more robust EMR capabilities and conduct research to ensure that our patients are receiving the maximum health benefits the technology can offer."

Using advanced EMR technology will not only improve health care, but also enhance communication among health care professionals, provide them with the latest medical information and assure that prescriptions are legible, accurate and economical.

Prescribing medications typifies how EMR systems can help improve a health care provider's effectiveness, as well as patient satisfaction and health. For example, a physician "writing" new prescriptions enters them directly into the patient's electronic record, using computer tools that help ensure the right medications are prescribed at the right dose and lowest cost. Refilling a prescription takes only a single click. Prescriptions can then be sent electronically to a pharmacy, where they are ready for pickup when the patient arrives.

"This has greatly improved clinical efficiency in our family practice clinics," said Susan Curtis, EMR project manager. "The average turn-around time for requests to refill prescriptions has improved over 20-fold."

When a patient comes for an office visit, the nurse or medical assistant takes his or her vital signs and enters the information directly into the computer, giving the doctor or other provider immediate electronic access. Physicians also enter information obtained during each visit directly into the EMR.

Using the EMR to document care has two major and immediate advantages: the information is instantaneously available for the patient's other providers who also use the EMR, and it eliminates unnecessary and burdensome paperwork.

"It has been estimated that doctors spend 38 percent of their time writing in paper charts," Zaroukian said. "Even then, the information is frequently incomplete, illegible or unavailable to others when needed. The EMR redesigns the processes of care to help resolve these issues."

Other benefits of EMR systems include:

• Test results and radiology images are automatically placed in organized tables providers can use to analyze, monitor and improve care.
• Automatically informing providers when equivalent medications are available at lower costs. The EMR also alerts providers to potential adverse drug interactions, improving patient safety.
• Secure provider access to electronic patient records at home, giving doctors the information they need to care for patients who require assistance after normal business hours.

"We have the highest level of security," said Michael Szkotnicki, the MSU HealthTeam's chief information officer. "Any data going out is encrypted and the system is behind a dual firewall. In addition, any access to data in the system is tracked. If you shouldn't be in a record, we'll know it."

EMR use is also incorporated into the medical school curriculum. Dubbed the "MSU Virtual Practice," it is what Zaroukian calls a "flight simulator" for health professions students.

"Students will learn to use the EMR to routinely enter patient information electronically," he said. "They will also use the EMR to learn how to provide care in an error-free environment, before they treat actual patients with complex diseases. As each student gains knowledge and skills, we can use data from the EMR to verify competencies in a realistic practice environment."

After years of planning and preparation, the EMR system was initially implemented in the MSU Department of Family Practice clinic, where it has been a major success. It is now being implemented in all MSU HealthTeam clinics, a multiphase process that should be completed by mid-2003.

"Over 130 computers have been installed for health care providers to access the EMR," Curtis said. "Interfaces are currently in place for transcription, radiology images and lab reports. Interfaces continue to be developed to facilitate electronic data exchange of other patient information."

With more than 200 faculty providers, as well as other health care professionals, the MSU HealthTeam provides primary and specialty care to the university community and general public. MSU HealthTeam providers are faculty and staff members of several MSU colleges and are active in patient care, teaching and research.

Initial funding for the EMR project included a grant of $550,000 from the MSU Department of Radiology.