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Dr. W. Joseph Ketcherside, Senior Vice President and Chief Medical Information Officer

It’s been almost a decade since Methodist Le Bonheur Healthcare (MLH) began the first phase of transition to electronic medical records (EMR). And the momentum hasn’t declined in the first healthcare data farming project.

“Physicians have been using EMR for labs, reports, and nursing documentation for over four years. Over half of the patient’s chart is already online,” said Dr. W. Joseph Ketcherside, senior vice president and chief medical information officer for MLH, which expects to be completely paperless by the end of 2009.
The advantages, said Ketcherside, are abundant.

“They mainly fall into improvements in patient safety and quality of care, decrease in cost of care, and improvements in clinician work day,” Ketcherside noted. “Electronic systems with decision support built in can help doctors do the right thing for patients, identify problems when they first occur or even prevent them, and make the record available to the doctor anytime and anywhere.”
Shorter stays, fewer errors, safer and a better quality of care are a few things patients treated at facilities with EMR systems can expect. And doctors and nurses have some benefits to look forward to as well. “Intelligent presentation of the data eliminates hunting for it. Once they learn to use it, efficiency is much better,” noted Ketcherside.

But it’s not all roses for health professionals making the change to EMR technology. Some are adopting it and pushing for more, while some are hoping to retire, joked Ketcherside.

“Some people handle change better than others,” he commented. “Most clinicians embrace it once they see the benefits and get used to the new ways to work.”
The ability to retrieve files that otherwise might be lost is another advantage of going paperless. The electronic data in an EMR system can be backed up and recalled.

“Witness the experience of doctors and hospitals during Katrina,” Ketcherside offered. “Those with electronic records were back in action within days, but paper charts were lost forever.”

How is electronic recordkeeping working at other medical centers?

“Those hospitals which are ahead of us have seen big gains in quality and safety, and many financial benefits,” Ketcherside said. “Once they have gone electronic, few clinicians want to change back to the old paper ways.”
The move away from those “old paper ways”— though beneficial in the end — is not an easy one. It means extensive evaluation and re-design.

“The technology is designed to support and enable the improved practices. This is coupled with extensive training and support to users to help them adopt new techniques,” said Ketcherside. “It’s an ongoing evolution and requires continued support by a team of clinicians trained in medical informatics.”

The predictive technology is part of a team effort with the University of Memphis Center for Healthcare Technology to help determine best practices.
“Our data farming project is a first for healthcare,” said Ketcherside. “Most of its use before was military. We hope this technique will help us model nursing workflow and allow us to predict the effects of workflow redesign.”

Data farming is a term coined to describe the practice of using a high-performance computer to simulate real-life situations and compile the data from the results of the simulations.

The medical field is abuzz with MLH’s continued data farming project — and with good reason.

“The excitement is the opportunity to dramatically improve the way we care for patients,” Ketcherside said.

MLH’s data farming efforts and its movement to paperless record keeping is a reflection of a medical field evolving to keep pace in the technology era.
“Pencil and paper is a 2,000-year-old technology,” noted Ketcherside. “Our paper charts in medicine have not changed much in 200 years. The rest of the world has taken advantage of centuries of improvement, and now healthcare records are, too.

“Our sepsis alerts at North have saved patients lives by identifying critical infections and alerting doctors. Our pharmacy alerts identify potential medication reactions before they occur. Doctors can make decisions with all the data in front of them instead of only having half the story. Nurses can capture patient information right at the bedside and have it available to all members of the care team instantly.”

MLH’s EMR project, said Ketcherside, is doing for healthcare what cell phones have done for communication.



February 2008

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