GLORIA BUTLER BALDWIN

The Institute of Medicine and the National Committee on Vital and Health Statistics identified health information technology (HIT) has one of the most powerful tools for reducing medical errors, lowering health costs, and improving the quality of care in physician practices.

One of the first hospital systems in the Memphis area to step up to bat in the move toward HIT, Methodist Healthcare, is on a $100 million journey with Cerner Corp., to integrate the entire Methodist clinical system into a one-chart electronic system. In the late 1980s, St. Jude implemented Cerner Corp.’s HIT solutions to improve patient safety and satisfaction, as well as automate its healthcare process, but a lot has changed in two decades.

Methodist senior vice president and chief medical information officer, Dr. Joseph Ketcherside, previously worked at Cerner as a software developer and designed a lot of the software now being implemented at Methodist.

“We actually started organizing all of this in 2000,” Ketcherside said. “This was really an issue of quality of care because, when you look at other industries across the board and how they handle information, they were able to do it better, quicker and provide better quality service to more people and cheaper. When you look at healthcare, it’s one of the most information intensive industries there is, but it was at least a decade behind the rest of the country in learning how to effectively use information. It was the realization we could do a lot more for our patients and do a lot more for our doctors if we’d do what other industries are doing. You can make things a business benefit by being more cost effective with some things, but those are increments like if you change the way the parking lot works. But, the way that quality improvement works with electronics, is you really take a giant step.”

Six Memphis Methodist hospitals have already implemented Phase 1 of the electronic transition by replacing some foundational business functions that were on different platforms and moved them into one. Today, it operates on a hybrid system where some records are on paper and others are electronic. Phase 2 will make Methodist Healthcare a virtually 100 percent electronic one-chart environment.

“When you look at the whole thing together, the cost over about a 10 year period for hardware, software, the people it takes to do the projects, it will add up to about $100 million, but it will pay for itself in benefits,” Ketcherside said. “When you just don’t have to store all this paper, pull a chart and shuttle it here and there, that’s part of how it will save time and money. But, there are more subtle ways–through improved process. The doctors can work from home, review a lab result and make a decision right now instead of waiting until tomorrow to come in and find the chart and look at it; you can have radiologists that can read images from three hospitals while in one place. You speed up the turnaround. Our average turnaround for an X-ray report was 96 hours before we started doing this and now it takes minutes. We used to print out results and stick them in the chart. Now, when the results come out of a machine in the lab, it goes within the chart within hundreds of a second so any doctor can see them anywhere at any time.”

William Kenley, administrator and CEO of Methodist North, said Methodist is working through a very rigorous implementation process, one aspect of which is the capital equipment function.

“We did an assessment and have a multifaceted equipment plan — hardware and wireless computers, and hand-helds throughout the system that are being put into place right now,” Kenley said. “We’re also going through a vigorous education process with associates that will be working within that environment and will be starting very soon with medical staff as well. It’s pretty extensive. This is a quantum leap forward in how we care for patients.”

In a March 2007 letter to The Washington Times, American Medical Association president William G. Plested III listed four factors hindering technology usage in the medical community: ensuring the privacy and security of patients’ electronic records, the high cost of health information technology, multiple competing systems, and limited guidance in choosing a system stand in the way of technology being used in medical practices.

“Only about 20 percent of physicians in practices employing 20 or more doctors have some form of health information technology and that rate drops among smaller practices,” Plested said. “With systems that don’t currently talk to each other and no national standard for interoperability, physicians are wary about spending $44,000 to implement a system that disrupts an established workflow and may become irrelevant in the near future….”

Kenley said a lot of research has gone into the transition and many assessments have been put into place to ensure that the rollout is successful and the money is well spent, with the main purpose to improve healthcare and save money.

“We think we’ve done a very good thorough job in development, but when you turn on the switch, you find out things you wish you’d done differently,” he said. “We want to ensure this will work for clinicians and staff before we move onto other facilities. We do have a roll out schedule, but it is built upon the fact that we’re going to ensure that the system here is stable and we’re gathering results before we proceed. But, the rollout at Methodist North is expected in November.”

Ketcherside added: “If you treat patients right up front, healthcare is better, faster and cheaper, so the patients are happier, as are the doctor and staff. This is big stuff. This isn’t a CD-ROM you buy at a store and install; there’s a lot of custom work to do. You’re changing the workflow–the way people work. That takes a lot of time, patience and effort for people in any organization.”




August 2007