Print
Email
Print Edition StoriesFriday, October 23, 2009
Lawrence General Hospital: A beacon of e-health success
By Julie M. Donnelly
MHT's Julie Donnelly: Life science startups finding investments
MHT's Marc Songini: Technology to keep seniors healthy
MHT's Efrain Viscarolasaga: Tech companies may have to wait for stimulus funds
Dr. Neil Meehan’s computer tells him there are three patients in the waiting room of Lawrence General Hospital’s emergency room, two in registration and one in triage with a nurse. As things heat up, he’ll adjust staffing levels in real time to avoid the kind of bottlenecks that give emergency rooms a rotten name.
“Before, it was a free-for-all. Clipboards were everywhere, there was no way to track the flow of people, and the bottlenecks would never go away,” Meehan said.
Meehan credits this electronic system, ED PulseCheck, sold by Wakefield-based Picis Inc., with reducing ER wait times by more than 30 minutes. It has also reduced the number of patients who throw up their hands in disgust and leave without treatment. That population is down to 1 percent from 6 percent of all ER patients.
Meehan said the most important outcomes are, so far, tough to measure. Meehan said recently an electronic alert warned him of a dangerous drug interaction, which sparked an idea for an alternate diagnosis. The diagnosis, Meehan believes, likely saved the life of a 38-year-old patient.
It’s too soon to tell whether success stories like the one at Lawrence General Hospital’s ER will fulfill the promise of those who believe that electronic medical records will chop large sums of money, perhaps billions, out of the nation’s health care system. Last February, as part of the American Recovery and Reinvestment Act, President Barack Obama committed $19 billion to jumpstart hospitals’ and doctors’ efforts to ditch the manila folders and clipboards.
The technology has been a boon to Lawrence General’s bottom line. The hospital saved $600,000 this past year in transcription services for dictated ER medical records. Meanwhile it has saved Meehan and his colleagues countless hours dictating those records.
Most impressive, it has brought in $5 million in additional revenue through one simple change. Nurses can now easily enter the stop time of an intravenous drip. It’s a crucial data point that assures reimbursement from insurers, and one that previously often got lost in the shuffle. But while this $5 million in extra revenue is good news for Lawrence, it’s an extra cost to private and public payers — one example of how increased hospital efficiency and record keeping can, in fact, add costs to the system.
The medical community is racing to be eligible for government reimbursements of $44,000 per doctor for “meaningful use” of electronic records by 2011. Those who don’t get on board by 2015 will incur penalties.
The majority of doctors and hospitals have a ways to go. The Massachusetts Hospital Association estimates that 25 percent of Massachusetts hospitals have some sort of electronic health records system. The MHA estimates fewer than half of the 20,000 doctors practicing in the state are online.
While some of the large Boston teaching hospitals have spent tens of millions of dollars developing their own integrated electronic health systems, community hospitals such as Lawrence General, with fewer resources, often must piece together a patchwork of different electronic solutions from outside vendors.
“We have 40 different kinds of software in place, from 30 different companies. There’s one for nutrition, one for billing, one for labs, two for radiology ... ,” said Lawrence General Hospital system analyst Paul Allain.
Every time the hospital adopts new software, it’s Allain’s job to create an interface so that the products can work together. He says it takes a few weeks to a few months to construct each interface. Most of the software applications require their own servers, and Allain, whose office looks like a computer graveyard, has to make room for them. Allain said that even as the hospital trims costs, his budget has grown 74 percent over the past four years.
Some costs were hard to foresee, like the hike in bills for air conditioning needed to keep all those servers cool. But Allain said the electronic upgrades generally pay for themselves in about 18 months.
Allain’s life will get easier when the hospital adopts a system called Paragon from Alpharetta, Ga.-based McKesson Corp., which is expected to supplant many of the current software applications, except those in the ER, the labs and the pharmacy.
The upgrade will change the procedures and the culture throughout the hospital.
“So when the patient comes up here from the ER, the doctors will call up to make sure they got there safely, and we’ll start filling out paperwork here,” said Christine Lees, a nurse on the oncology and diabetes floor. She presides over a bookshelf full of binders stuffed with forms with neatly punched holes — some printouts, some faxes and some handwritten.
Lees’ floor, like the rest of the hospital outside the ER, is not on an electronic system and will be transitioning to Paragon over the next several weeks.
She and her colleagues must fill out four different types of forms for each patient that is admitted. Several times a day, a worker from the medical-records department has to come up and collect them. If doctors or nurses need an old file, they might have to wait days for it to be retrieved from a storage facility off-site. As it stands, the system is loaded with pitfalls.
“This might sound simple, but one of the biggest problems we have sometimes is trying to decipher a doctor’s handwriting,” Lees said.
RSS Feeds
Comments (1)
Please Login/Register to post comments.