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County offices shifting to digital patient records
Cedars Health family nurse practitioner Rhonda Mclaughlin watched Monday as medical assistant Katherine Bailey entered patient information using electronic health records software. The two hospitals in Fremont County and most of its clinics have shifted away from paper charting. Photo by Alejandra Silva

County offices shifting to electronic patient records

Feb 4, 2014 - By Alejandra Silva, Staff Writer

The change should help improve the "quality, safety, efficiency" of the health care system.

Physicians and medical staff in Fremont County are making the transition from paper-based medical records to electronic health records to keep up with a national goal of having an easier and safer patient delivery system.

The Health Information Technology for Economic and Clinical Health Act supports the "meaningful use" concept of collecting patient information in computers and no longer saving it on paper.

According to the Centers for Disease Control and Prevention, meaningful use should help "improve quality, safety, efficiency," and reduce health disparities. The system also is intended to "engage" patients and families in their health, improve care coordination and protect privacy and security for personal health information.

Meaningful use

The effort is led by the Centers for Medicare and Medicaid Services. The federal agency grants incentive payments to hospitals, and other health facilities or health professionals that show they've upgraded their data systems, adopted the electronic health records use, and are successfully using the model. Since the incentive program was first offered in 2011, front desk receptionists, nurses and physicians began inputing patient information on computers or hand-held devices instead of using paper records.

The EHR system reimbursement is offered in three stages, and groups have until 2015 to adopt the system and advance in its use.

Riverton Memorial and Lander Regional hospitals are getting ready to start the second stage of the EHR-MU, said clinical informatics nurse Rhonda Dailey. Dailey has provided one-on-one staff training on the use of the EHR system.

"We're still in our infancy stage," Dailey said.

The reimbursements range from roughly $44,000 to $63,000. According to the CDC, groups are not required to participate in the program, but if they don't join by 2015, "negative adjustments," which increase over the years, are applied to their Medicare and Medicaid fees.

HealthAffairs.org reported in 2013 that in a survey of U.S. hospitals, only 44 percent said they have and are using EHR systems. The surveys also suggested that urban hospitals were outpacing rural hospitals in the adoption of the systems.

Efficient use

HealthCare.gov described the U.S. health care industry as one of the few still relying on paper records. The website states, "using electronic health records will reduce paper work and administrative burdens, cut costs, (and) reduce medical errors."

Physicians at Riverton Memorial and Lander Regional hospitals are liking the use of EHR, Dailey said. Each exam room is equipped with a computer that helps medical staff input the information collected from a patient during a visit. Physicians in Lander use tablets to help them write prescriptions, which are then printed out for patients to take to their pharmacies.

The efficiency of the new system is evident when either hospital has immediate access to a patient's information from one computer database. Before that, Dailey said, staff would have to request the medical records to be faxed, which added more time to a visit.

A physician also can now write a prescription or input additional data into the individuals' file, right from home.

"Now, they can just log on and access that information," Dailey said.

It seemed to have been faster to scribble the prescription on a notepad, Dailey said, but several months of training was done to ensure physicians could make the transition from pen and paper to a keyboard and computer screen.

Some physicians are able to send electronic prescriptions to pharmacies for patients to pick up at their convenience. This feature is being used at Cedars Health in Riverton, said family nurse practitioner Rhonda Mclaughlin.

"E-scribing saves us a lot of steps," she said.

The clinic recently opened in Riverton and requires new patients to provide their initial registration on paper. As for the EHR system, Mclaughlin said she "loves" it.

"They caught on pretty good," she said, adding that the clinic's version of the system is more user-friendly than ones she has worked with before.

Despite an easy-to-use system, Mclaughlin said patients may not like how physicians will have their eyes more on a computer screen than the individual.

Cedars Health medical assistant Katherine Bailey said she found the absence of paper charting easier, especially when she has to perform several tasks between the front desk and the exam rooms.

"It works well when I have to go back and forth and be in other positions," Bailey said, adding her only troubles come up when it's time to turn on the system at the start of business.

Cedars Health also uses an iPad for debit and credit card payments and is planning to use hand-held devices in the exam rooms.

Mclaughlin said there is less paper to deal with in the new system and by simply hooking up to the computers in the office, all the essential information can be accessed quickly.

Dailey said the paperwork is not being discarded, and the hospitals keep all records on file and in storage.

"We still have the paper in case the computers go down," Dailey said.

Other clinics in Riverton said they have been using the EHR system since November and are gradually making less use of paper charts in the offices.

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