EMR Technology Ranks in Top 10 Percent of U.S. Hospitals

MidMichigan Health is ranked in the top 10 percent ofU.S. hospitals in its progress toward implementation of electronic medical record (EMR) technology. This ranking was provided by the non-profit Healthcare Information and Management Systems Society by surveying 5,071 non-federal medical/surgical hospitals.

Electronic medical records are replacing paper patient charts in hospitals and

physician offices throughout the U.S. The electronic medical record

captures physician notes, test results, medication records and all information related to each patient’s medical diagnosis and treatment in a computerized, digital file. EMRs are very often being required by regulatory agencies and insurance payers.

“This ranking demonstrates the level of sophistication of health care organizations in their implementation of EMR technology with Stage 0 meaning the hospital is still using paper charts and Stage 7 being the highest. MidMichigan is at Stage 5 in its implementation process,” said Michael Larson, MidMichigan vice president and chief information officer.

Although MidMichigan is involved in continuous quality improvement to improve the EMR process, it has fully implemented hospital inpatient EMRs in its four hospitals in Midland, Alma, Clare and Gladwin and in August 2012, completed installation of EMRs in 95 percent of the 65 physician practices located throughout the region.

The greatest advantage of the electronic record is for the safety of patients. As an example, Larson described how medications are tracked by using the EMR. “There is now a closed loop medication administration process from the time the patient is admitted to the hospital to the time the patient leaves the hospital,” he said. The process includes bar-coded medications and bar-coded name bands worn by the patient to be sure that each and every medication matches each patient and the dose they receive every time. There is a five-step confirmation process and oversight by the physician and a pharmacist. “This process allows us to administer medications as safely as possible,” Larson added.

“Although MidMichigan has always been good at medication safety, we will gauge over the next year just how safely we are able to administer medications,” he explained.

In the Emergency Department the EMR has provided a real-time tracking board for knowing each patient’s level of care. The board tracks whether patients are waiting for lab or testing results, waiting for admission or discharge, who the patient’s emergency physician is and lists his or her nurse. The safety benefit to patients is that the acuity of level of each patient sets the needs for treatment and all staff know what needs to be done next.

Electronic records at MidMichigan also improve safety for pregnant mothers and their babies, before and after birth. Two enhancements to the EMR called FetaLink and PowerChart Maternity integrate a baby’s record with the mother’s, and provide real-time fetal monitoring. The record begins at pregnancy and continues through postpartum discharge as it follows progress toward delivery by recording measurements of the baby’s size, graphing labor and providing a patient’s history of other pregnancies, among other details.

MidMichigan Health is the only obstetric provider in the region that utilizes these highly integrated mother/baby records and is doing so at MidMichigan Medical Center–Midland and MidMichigan Medical Center–Gratiot.

MidMichigan is not finished improving electronic medical technology. Next steps include implementation of a system in which the hospital patient record and their doctor’s record are able to better share data. This system is known as dbMotion and creates a longitudinal record that allows physicians to view records from inpatient admission and outpatient testing and treatment in the patient’s office EMR. For instance, if a patient is discharged from the hospital and returns to the physician’s office for an appointment a week later, the physician will be able to view the treatment, medications prescribed and laboratory and other testing records from when the patient was hospitalized.

Electronic records are key to communicating with outside organizations as well. EMRs enable MidMichigan Health to capture clinical documentation and demonstrate quality of patient care to reporting agencies and payers. Health systems who report electronically receive “meaningful use” reimbursement from such organizations as the Centers for Medicare & Medicaid Services (CMS). This is projected to be as high as $25 million over the next four years.

Another upcoming electronic technology step for MidMichigan is participation in one of Michigan’s Health Information Exchanges (there are currently two). These exchanges build the infrastructure to allow patients’ medical records to be more portable. For instance, a patient’s history of allergies, immunization record, medications and other basic information follows the patient when traveling within the state. This helps hospitals and emergency rooms deliver safer care. “With this portability and access to the EMR, a patient entering a hospital or emergency room for the first time is not a stranger to the new health care provider,” Larson said. All Michigan health systems and hospitals will be required to participate in an HIE, and MidMichigan plans to identify within the next three to four months which HIE it will join.

During the coming year, MidMichigan will also be building a patient portal in which patients may access their health record electronically. The portal will enable patients to ask follow-up questions of their physician, schedule appointments, check medications and otherwise interact with their medical record.

MidMichigan Health is a non-profit health system headquartered in Midland, Michigan. It covers a 14-county region with medical centers in Alma, Clare, Gladwin and Midland, as well as urgent care centers, home care, nursing homes, physicians, medical offices and other specialty health services. MidMichigan has 6,500 employees, physicians and volunteers. Last year, MidMichigan Health provided $75.5 million in charity care and other benefits to improve the health of people in our communities.