At a hospital filled with the latest technology, University emergency room doctors no longer have to carry a clipboard and scribble notes. Now, they are followed by scribes, who use a laptop to record diagnoses, symptoms and prescriptions, and then save the information into a new records system.
Marshall Ruffin, the hospital's chief technology and health information officer, explained that the scribes are just one part of an effort to create a single central system for the hospital's electronic records. The University will work with a company called EpicCare during the next two years to properly organize the new records system, Ruffin said, explaining that the hospital chose EpicCare to assist in the transition because of its reputation. The company already has contracts with the health systems at Stanford, Kaiser-Permanente and the University of Pennsylvania.
"The U.Va. Hospital has always been a leader in electronic order entry," Ruffin said, "and so we're in a good position to start working on a single integrated system."
Ruffin explained that other institutions across the country are starting without this technological innovation and advantage, making it much more difficult to standardize and digitize records elsewhere. Still, there will be hurdles to make these necessary changes to the University's file systems, he added.
At this time, Ruffin said, the data entry changes are needed because if patient data cannot be sent between different hospitals and practices, "we can't expect to systematically improve health care."
Currently, there is a national effort to create a system of centralized records called the Nationwide Health Information Network, Ruffin said. President Barack Obama also proposed a five-year plan to standardize and digitize records during his campaign, and the U.S. Congress incorporated funding for it into the economic stimulus package, which committed $30 billion to help transition hospitals with the hope of increasing efficiency and eventually monetary support. Starting in 2011, Medicare and Medicaid will reward bonuses to doctors and hospitals with electronic record systems, and in 2015, impose penalties on institutions that still use paper systems.
The hospital's ongoing changes to procedure, therefore, will have additional benefits and prove cost-effective over time, Ruffin said.
"In the long run, a standard system of electronic records will help improve health care in this country," he noted.
Randolph Canterbury, Medical School associate dean for admissions, said the Medical School is preparing its students to enter hospitals with experience using a fully computerized system. Canterbury explained that students begin learning about electronic records during the first week of class.
"The system presents the opportunity for us to create computer-simulated patients with electronic medical records that the students can manipulate," he said. As part of their training, students can order tests and prescribe medications for simulated patients created from the digital records.
"Undoubtedly, in the future, all physicians and health systems in the U.S. will use a single electronic medical record," Canterbury said, "[and] although our health care system has not gotten to that point yet, we are preparing our medical students for this eventuality."
The University may be planning ahead with its own tools and additions, but this final country-wide innovation is advancing slowly.
"It's going to be a long time before doctors and the public are able to get used to a new system," Ruffin said.
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