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Shortly before I was born my dad worked on a major project for Bank of America in California. What emerged was the remarkable technology of magnetic ink encoded checks. It allowed for rapid processing of hand written checks using magnetic and electric scanning principles coupled with the rapidly advancing computer technologies. This process was a major step in the computerization of retail banking in the United States.

A few years later, as a boy I had the privilege of watching two technological marvels. On weekends, my dad, who worked for IBM in New York, would take us to the construction site of the twin towers - the beacons of the World Trade Center in downtown Manhattan. Shortly thereafter a major NY bank hired him to oversee the computer operations for their stock transfer division. I then had the privilege of walking inside an early 1970's state-of-the-art financial center computer room and learning how the financial sector of the economy was utterly transformed.

A few years later, in the early 1980's, I found myself working for a major Wall Street Bank during the major enhancement of the SWIFT system - the system that empowered overnight (and now instant) financial transactions between all of the financial institutions of the world.

More than 25 years later we are on the apex of a similar revolution in healthcare. The paradigm shift has been slow starting just as it was, at first, in the financial world. In healthcare, it began with scheduling and billing systems for hospitals and medical practices. Then insurance based transactions emerged via electronic claims clearinghouses. Now, we are in the uptake phase of a nationwide use of electronic medical records (EMR), also known as electronic health records (EHR).

At a recent summit for users of electronic medical records, The West Clinic was identified as one of the most advanced users of EMR technology for cancer clinics in the United States. Our experience has certainly revolutionized clinical quality and operational efficiency - yet we are only on the cusp of the potential that EMR/EHR will bring.

Effective implementation of EMR is a multi-year process. First, there is the planning phase - determining the hardware, software, operational needs, and forming the implementation team. Next, there is the need to build a clinic wide enthusiasm for the effort. The importance of this phase cannot be underestimated. Without everyone completely on board, there are speed bumps that will greatly impede progress. The next step is implementation - usually done in phases. Having an implementation team that includes physicians, nurses, administrators, IT, and others will help ensure that all are staying on the path rather than straying down needless rabbit trails. Lastly, there is the ongoing efforts of process improvement, feedback to users, and enhanced use of more technologically challenging features within the EMR.

In the case of The West Clinic, the whole process took about five years to fully implement - about two years of planning, one full year of implementation and two years of perfecting the use, upgrades, and other features.

The benefits of use of EMR are too numerous for a brief article - but here are a few:

• Patient information and the patient health record are accessible in real time. There are no more chart searches that are common inside medical practices.
• Health information - including labs, pathology, imaging, and other salient data is all neatly packaged within the health record for each patient - often in data points, graphs, colored bar charts, and actual images.
• Defined clinical pathways are more easily implemented and the data analyses to review adherence is readily available.
• The practice of evidenced-based medicine - according to the latest literature, research, and data is achievable. The national standard guidelines are all included in the efforts as well as the minute details of best practice. In oncology, the changes are very frequent. We are able to enhance the quality of care even prior to the information being disseminated at large meetings.
• Enormous amounts of data are available to align best clinical practice with best business practice - empowering the business model for best quality medicine.
• Health information is easily portable from one provider to another - in accordance with HIPAA guidelines.

The revolution of the use of Information Technology (IT) in healthcare is upon us. Within a decade, that which took a generation in the financial industry will transform the healthcare sector. The early adopters and late adopters are about to find themselves bunched together in this massive movement of change.

STEVE COPLON, CEO
The West Clinic
Memphis Heart Clinic

Tags:

EMR, HER, HIT, STEVE COPLON, The West Clinic

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