EMR Implementation & HITECH Act Blog

Want Proof That HIT and EMRs Can Work?

We know that many of you are asking if, at the end of the day, Health Information Technology (HIT) will really work. What benefits will you see after investing all this time and money in HIT?  Well, we can say that not only can HIT work, but it can provide powerful, tangible benefits.

To see how well HIT can work, look no further than the Columbia Basin Health Association (CBHA), a group of four clinics in rural Washington State.  CBHA serves roughly 25,000 patients per year — about half of whom are low income — in a 3600 square mile area.   The entire CBHA system is paperless and has migrated 100 percent to electronic medical records (EMRs).

Improved Medical Care

According to the National Center for Health Statistics, rural Americans are more likely to suffer from chronic health conditions, so CBHA staff decided to track the percentages of 1302 diabetes patients having the recommended foot and eye exams in the previous 12 months.  At the beginning of 2008, those percentages were 31% and 37%, respectively.  By June, they had increased those numbers to 86% and 63%.

By using the HIT’s ability to track and aggregate patient contact data, providers showed similar gains in screening levels for both depression and osteoporosis, and improved child immunization levels to above 95%.   Across the board, their performance was among the best in the entire state.

Improved Efficiency

Here are some numbers from the CBHA story that really make the case for the speedy implementation of EMRs and HIT:

• 100% of dental appointment slots are filled
• No-shows cut by 50%
• Provider productivity – patient contacts – almost doubled
• Investment in a pharmacy management system recovered in 3 years due to labor savings

Patient safety has improved, especially in the area of prescription management.  Patient wait times are shorter and providers are spending more time with each patient.

A Long and Winding Road

Make no mistake, the process of getting to where they are today has been a long one.   As outlined in the 2008 application for the HIMSS Davies Award, CBHA started looking at EMRs in 1998.   The board of directors had to be sold on the idea.  The main selling point:  a vision of provider productivity – each of 10 providers would see 21 patients per day and have charts compliant and complete within one hour, leading to savings of $120,000 per year just in transcriptions.

Once the board gave the go ahead, the providers had to be sold on the idea.   They hopped on the train, but brought with them a long list of requirements, including:

• decision-support tools
• electronic prescriptions
• automated lab results for both inside and reference labs
• secure messaging and triage documentation

Once the board and providers signed off, the 16-member EMR committee set about implementing a variety of tools that would meet the needs of all the various stakeholders.

Administrators implemented both EMR and practice management programs.   After connecting their various locations with T-1 lines and fiber optics, they added integrated pharmacy and laboratory programs, document management and radiology imaging programs, plus patient education terminals linked to Web-MD.

In the end, CBHA has grown and evolved a system that puts them at the leading edge of EMR around the country.  In addition to the day-to-day benefits that have accrued as a result of their investment in EMR, the numerous awards, and even the personal recognition of the Secretary of HHS, the most important gain has been the ability to give better medical care at a lower cost.   And that’s what HIT is supposed to do.

Rich Silverman
PCHS Blogging Team

Public Domain photo by Martine Cuaron courtesy of Wikimedia Commons

Posted by PC Healthstop Blogging Team