Electronic Health Records Improve One Step at a Time: Providers optimistic about future of health communication.

AuthorOrr, Vanessa
PositionHEALTHCARE

It's ironic that "on paper" the idea of electronic health records (EHRs), which provide an easy way for physicians, hospital systems, and patients to keep track of a person's medical history, makes a lot of sense. In practice, however, the process of creating a database where these records are safely and efficiently available to everyone who should have access (and protected from those who should not) has not been without its share of problems.

The good news is that while there have been some difficulties, the majority of health providers in Alaska are moving toward a system that will enable more complete medical information to get into the hands of care providers more quickly while making it easier and more convenient for patients to see test results, pick up prescriptions, and travel around the state without having to carry their medical information with them.

"While we went live with our first EHRs in 1998 and still use the same vendor for our main facility, it doesn't look anything like it did twenty years ago," says Kirsten Kincaid, RN, manager of clinical applications at Bartlett Regional Hospital in Juneau. "We've gone through many upgrades to improve functionality."

Integration Challenges

One of the biggest challenges that healthcare providers face is getting records systems to talk to each other--not just from one hospital or provider to another but even within their own facilities. For example, Bartlett Regional Hospital uses a "best of breed" approach, utilizing MEDITECH for inpatient and outpatient hospital settings, eClinicalWorks for ambulatory, Plexus for anesthesia, and T-System for the emergency department.

"Best of breed is seen at healthcare organizations across the country," says Kincaid. "While some of the largest organizations may use one vendor, like Epic, smaller organizations, sometimes due to cost constraints or other issues, use a variety of different products."

Even when entities share a domain, such as the Southeast Alaska Regional Health Consortium (SEARHC) and the Alaska Native Tribal Health Consortium (ANTHC), some information may not be shared among providers if they are not on the same system.

"For example, an oncologist might come to Juneau once a month to visit with your patients--how do you share information with that person's practice?" asks Peter Apathy, SEARHC IT project manager. "While the interoperability piece is getting better, it's not quite there for us, though we're pretty darn close."

Even hospitals that use the same system may have training issues, as different departments may not always see the same screens. "We use Epic software, and while it's pretty easy to learn, not everyone sees the same menu," explains Alaska Regional Hospital's Ethics and Compliance Officer Tom Kent, who formerly served...

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