Using technology to transform the delivery of healthcare is the end goal for Emory Healthcare's $50 million electronic medical record initiative. But the multi-year project is much more than converting paper medical records to an electronic, "paperless" format.
The Emory Electronic Medical Record (EeMR) will increase efficiency and enable healthcare providers to make the best decisions regarding patient care, ultimately improving quality and safety while reducing costs, says William A. Bornstein, MD, PhD, chief quality officer for Emory Healthcare.
EeMR allows physicians and other healthcare providers to enter patient information and orders directly into computer terminals. The technology responds with useful just-in-time information such as reminders and alerts about drug interactions, and even assists with administrative activities such as coding and billing.
EeMR will directly impact more than 7,000 Emory Healthcare employees, including physicians, nurses, pharmacists, therapists, nutritionists, unit clerks, schedulers, administrative staff, and others involved in patient care.
"One thing that makes Emory's project unique is the level of integration across multiple inpatient and outpatient settings," says Dr. Bornstein. Physicians will also be able to access patient medical record remotely via the web using encryption and password protection.
Emory has been working with Cerner as a development partner in its electronic PowerChart system since the early 1990s. Phase II of the current initiative, in which Cerner is also a partner, began in 2002 after the completion of Phase I, the installation of the system's technical infrastructure and hardware, as well as the Enterprise Master Patient Index, software that tracks each patient using a unique internal identifier number.
The $50 million cost includes a $27 million initial commitment to EeMR, as well as associated technology investments needed to improve clinical workflow and the cost of the PACS system.
Phase II rollout of EeMR began in late January, starting at Wesley Woods Hospital, then moving to Emory Crawford Long Hospital, followed by Emory University Hospital. The Emory Clinic began gradually implementing the programs, a section at a time, in February. This laid the foundation for Phase III, which supports electronic prescription writing and will support computerized physician order entry and eventually, bar code verification at the time of medication administration as well as other advanced functions.
"In a system the size of Emory Healthcare, changing over to an electronic medical record is a monumental undertaking. Along with the installation of new technology, extensive education of our staff is required," says Dedra Cantrell, RN, Emory Healthcare's chief information officer.
Implementation of Phase II required the scheduling of nearly 900 separate training classes. As new software programs went live, 500 ACEs - employees trained as Application Content Experts -- were available during each shift to answer questions and troubleshoot problems. Most users have received two hours of classroom instruction, while physicians are being trained individually.
Inpatient computerized physician order entry (CPOE) is slated to begin in 2006. This will be a large step in the transformation of care. Not only will CPOE help eliminate imprecise and incomplete communication among doctors, nurses, and pharmacists, but it will also provide real-time decision support to help reduce adverse drug events and other errors. Organizations such as the Leapfrog Group and the Institute of Medicine advocate using CPOE to minimize medical errors, the eighth leading cause of death in the United States.