Michelle Rindels
Staff Writer

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June 21, 2010
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Record collection rocks doc's world


A lot can go wrong with paper medical records - just ask Kathy Morris, a nurse and staff development director at Golden Empire Convalescent Home.

Important data gets buried in old files. Nurses get distracted and don't communicate information at shift changes.

Illegible handwriting? It's enough to make her cringe.

Morris firmly believes electronic medical records - shared instantaneously among doctors through a countywide network just getting off the ground - will change all that.

"That kind of speed is incredible compared to what we had," Morris said. "It brings the level of care up."

Sierra Nevada Memorial Hospital is spearheading a $1.3 million campaign to create a paperless network of 80 medical providers in the county, including the hospital, convalescent homes, public health clinics and even schools.

It's called the Greater Sierra Integrated Health Organization, and it will make Nevada County one of the most connected health care communities in the United States, hospital officials said. They hope to bring all local health care providers on board over the next three years.

After starting the project in 2005, the hospital just finished the technical infrastructure capable of handling such a high volume of information. Grass Valley general practitioner Dr. Chris Claydon was the first independent physician's office to use it, logging in last week.

The system will allow doctors to renew prescriptions through e-mail, rather than time-consuming runs between doctor and pharmacist. It will allow all of a patient's doctors to access and update a single, centralized medical record, eliminating the need to fax documents between offices - a transfer that invites human error.

Getting doctors on the same page in a patient's treatment can prevent duplicate tests and potentially fatal drug interactions.

"Over time, people will have greater confidence that there's a complete record," said SNMH Foundation Executive Director Kimberly Parker. "People will have greater confidence in their own health care."

A year ago, President Barack Obama earmarked $19 billion to help medical providers across the nation make the switch to electronic records.

Hospital officials had the idea before that: They have been keeping a partial electronic database since 1993 and back up 75 percent of hospital health records in electronic form.

But most Nevada County physicians do not: 85 percent still use pen, paper and color-coded file folders instead of sophisticated, expensive software.

Paper records form expansive libraries of file folders in each doctor's office. Some patients at Golden Empire have enough medical records to fill entire file cabinets, Morris said; state law requires medical providers keep all records for seven years.

Now, physicians can plug into the Greater Sierra Integrated Health Organization, a computer system already filled with two years of hospital medical records. They can update those existing records with information from office visits with patients, and phase out the paper libraries over time.

Not all doctors are on board with the project. For small practices, the start-up costs are prohibitively expensive, averaging about $30,000 for computers and software, plus annual maintenance costs and staff time.

But the hospital is hoping to make the move attractive by shouldering 85 percent of the cost. SNMH scored almost $800,000 in federal and grant money, and will use another $550,000 from the hospital foundation to complete the project.

Doctors on the system will pay about $3,000 each year for software upgrades and technical support from the hospital.

The software, eClinicalWorks, was chosen from about 50 other programs and is now the most popular software in the U.S.

It will allow more than just an exchange of records. A patient portal will connect patients and doctors through e-mail. A database allows doctors to quickly check a patient's insurance eligibility.

County officials will use some of the data - minus patient identification -to track illness outbreaks, according to Nevada County Public Health Director Dr. Karen Milman.

Security for the system is advanced. All data is encrypted and password protected, so only authorized medical personnel can access it. Patients have control over who sees the records and can opt out of sharing the information with specific health care providers.

A learning curve

Implementing the program has been smooth so far.

"It was flawless the day we went live," said SNMH Director of Information Services Mark Freitas.

But for medical workers used to scribbling all notes on paper, the transition can be daunting. When a new provider comes on board, hospital personnel train the provider's office staff over a period of 10 weeks.

"It's hard for people who aren't computer trained," Morris said. "But we've taken them by the hand, and most end up saying it's not as bad as they thought it would be."

To contact Staff Writer Michelle Rindels, e-mail mrindels@theunion.com or call (530) 477-4247.

Implementing the program has been smooth so far.

"It was flawless the day we went live," said SNMH Director of Information Services Mark Freitas.

But for medical workers used to scribbling all notes on paper, the transition can be daunting.

When a new provider comes on board, hospital personnel train the provider's office staff over a period of 10 weeks.

"It's hard for people who aren't computer trained," Morris said. "But we've taken them by the hand, and most end up saying it's not as bad as they thought it would be."

To contact Staff Writer Michelle Rindels, e-mail mrindels@theunion.com or call (530) 477-4247.


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The Union Updated Jun 21, 2010 11:57PM Published Jun 21, 2010 11:53PM Copyright 2010 The Union. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.