As part of legislation signed by President Obama, hospitals across the country are being required to convert conventional medical record keeping into completely digital operations.
Humboldt General Hospital (HGH) in Winnemucca, Pershing General Hospital (PGH) in Lovelock, and Battle Mountain General Hospital (BMGH), which serves Lander County, are all in the process of converting to a new Electronic Medical Record (EMR) system.
As required by the American Recovery and Reinvestment Act of 2009, the president earmarked $19 billion as part of a stimulus package that would go toward reimbursing healthcare providers to get their systems converted by a 2015 deadline.
For smaller and more rural hospitals like those in the region, local administrators say that federal funds to get the implementation done might not alleviate the financial impact.
"Even with the stimulus, rural hospitals are likely to take a hit," said Lora Zendejas, Humbolt General's health information management director.
PGH's Chief Executive Officer Patti Bianchi concurred: "We are spending hundreds of thousands of dollars to get our systems in place, and it's more difficult for smaller hospitals like ours."
Part of the vital process for hospitals has been training and getting staff prepared for the conversion process. "(We have) made a significant commitment to training and education for our EHR (Electronic Health Records). It ends up that we have to continue to work with all staff to overcome concerns about using this system and becoming familiar with the differences when it is compared to the system we used to use," responded Battle Mountain CEO Phil Hanna.
Zendejas noted that, while some physicians have been reluctant to make the needed changes, the system can be tailored to each doctor's particular requests - easing the transition. "We have made sure to ask staff for input, and in particular, doctors are able to access templates to customize the way they dictate and document records," she said.
For patients, accessing their own medical records will be easier thanks to various 'patient portals' the hospitals are implementing. They will be able to log into an area on the hospital website after verifying their identity and registering in person; only then would they be able to have access, review and print any records that are available. In compliance with Health Insurance Portability and Accountability Act (HIPAA) privacy regulations, certain information will not be accessible, however.
"We will block out an STD result, positive drug screens, and mental health information, for example. There is certain information that is private and we still want our patients to get results and advice from the doctor in person," replied Humboldt's Zendejas. BMGH has a similar policy. "The patient has to register through the hospital to get access to their medical record. (They) can't review all raw data through the patient portal, but all tests results and other summaries will be available," added Hanna.
Hospital officials said the benefits of converting to an EMS system are numerous - including the eventual elimination of all paper records. "Safety-wise it will be much better. Now we will be able to know who has accessed a certain record since there will be a 'digital mark' left-you could never really be sure with paper files," noted Bianchi.
According to Hanna, availability will be one of the prominent improvements of the new systems. "One of the major differences is the ability of a medical provider to have access to all the patient records that are available without hunting down paper copies of these records. In a critical situation it can be vital to treating a patient and in more routine situations it can enhance the process of making a diagnosis," said Hanna.
Zendejas said that, while paper records will eventually be completely eliminated, HGH's plan is to keep conventional files stored and available for at least 10 years from the date of the patient's last noted visit.
According to healthland.com, reasonable conversion costs could be around $500,000; government incentives and medicare reimbursement could be any where from $175,000-$400,000. HGH has the largest local inpatient capacity with 52 beds. PGH has 38, while Battle Mountain has seven available. For more specific area-hospital information please see http://www.hghospital.ws/Patient_Info/Medical_Records.aspx, pershinghospital.org, or bmgh.org.
Contact R.M. Contreras at r.contreras@winnemuccapublishing.net.
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