The Medical Group Management Association (MGMA), through its e-connection newsletter recently published data on patient expectations for use of electronic medical record systems, email, and web-based data entry. The results are consistent with our decisions to push forward rapidly with EMR implementation, develop secure e-communication strategies, and the use of patient entry of health histories on the web.
Connecting for Health, a coalition of 100+ public and private organizations
found that 40% of Internet users surveyed assumed their physicians and hospitals
used EMRs, computerized physician order entry and other technologies to manage
their patients' health care information. In reality, fewer than 10% of physicians
and 20% of hospitals use EMRs. They also reported that 70% of consumers who
used the Internet would use an online personal health record to store immunization
records, track medication use, look up test results, and transfer medical
histories electronically to new physicians. Over 2/3 would like to be able
to e-mail their physicians.
At the 10th Annual Logician User Group Symposium last month, executives from GE Medical Systems – Information Technologies (GEMS-IT) announced that Logician Ambulatory (as it is now called) will undergo a name change to reflects its position as a new member of the GEMS-IT family of health information technology products, collectively called CentricityTM Enterprise. Logician will be combined with the Millbrook practice management solution as an integrated suite that will be called Centricity Physician Office. The Logician EMR part of this suite will be renamed Centricity EMR. The name transition will occur over several months beginning Fall 2003.
The full listing of Centricity Information Systems products are listed below and can be found at: http://www.gemedicalsystems.com/it_solutions/infosys_center.html
Following his well-received presentation “Ambulatory Anywhere Health Care: Using Logician with Wireless Tablet PCs” at the 10th Annual Logician User Group Symposium in Portland, OR, Dr. Zaroukian was voted President-elect of the organization. The Logician User Group is a national organization of Logician users whose mission is “to promote the optimum use of the Logician® ambulatory electronic medical record system by enhancing communication among users and quality interaction between Logician users and GE Medical Systems.” Dr. Zaroukian’s presidential term runs from 2003-2006.
After months of planning, meetings, inter-institutional network infrastructure development, software programming, testing, refinement and monitoring, we are now confident that we have the technology ready to allow laboratory test results to be electronically transmitted from Sparrow Regional Labs to the Logician EMR. To test the system in the fully live EMR, I have been receiving laboratory results for the past week and am comfortable that the system is accurate and reliable. For those interested in an overview of the interface development process, please view: Lab Interface Project Overview.pdf
It is important to note that the lab reports that will be coming over electronically do not include pathology reports (e.g., biopsy reports, Pap smears), which will require an additional interface because Sparrow uses a different computer system for pathology reports. We also do not yet have an interface developed for laboratory results coming from Ingham Regional Medical Center or other labs. All such reports will continue to come in as paper documents until such time as an interface is available from the outside institution. We will be setting up planning meetings with IRMC to build an interface to its laboratory reporting system as well.
It is also relevant to note that in the beginning, some but not all laboratory results will automatically populate flowsheets to allow for tabular and graphical trend analysis over time. While over a thousand of the most commonly ordered tests will link to flowsheets, there are over 10,000 tests in Sparrow’s laboratory system, and it will take time to get all of the ones that might be useful to you, so please let us know if you have specific laboratory test results that you would like to be sure can be put into and graphed in a flowsheet.
While it would be technically simple to “flip the switch” to allow all lab results on all patients of all providers to flow immediately and directly into the EMR, patient care quality requires that HealthTeam providers and staff know what to do with the results in the EMR when they get them, which means having workflows (or protocols, as they are sometimes called) in place in clinics for handling the following tasks:
I have attached files that include examples of workflows for handling lab results (and radiology reports) to illustrate some of the issues listed above. The EMR clinical implementation staff is working with each clinic to help them understand and implement these workflows or adapting them to their own individual clinic needs. Please click on the following links to view the files relevant to each specific clinic role:
Once workflows are in place in a given clinic and staff members have been “in-serviced” on handling lab results in the EMR, we can turn on the electronic transmission of lab results for that clinic. Providers will be given a document that outlines these tasks as well as a link to the EMR web site where the instructions are also available.
To ensure that clinics are comfortable that they are able to handle lab results in the EMR without paper, we will have a brief interval in which lab reports also come to the clinic as paper reports, which can be discarded if the clinic is comfortable that it is handling lab reports successfully in the EMR, at which time the printing function will be turned off. Remember that once you begin receiving laboratory results electronically, it will be important to log in to the EMR frequently to check and sign off on laboratory results. For those of you who have not yet set up your web browser for logging into Logician from home or elsewhere, I will be sending along instructions for how to do so in a separate message soon.
In summary, you can begin receiving Sparrow lab reports on your patients as soon as your clinic is ready to handle them. The EMR implementation team will continue to do all it can to assist clinic managers and directors in completing workflows so the lab interface can be turned on for your clinic and your patients as soon as possible. Several clinics will begin receiving electronic results between 12/31/02 and 1/6/02. Please let your EMR implementer (Sandy Krum – firstname.lastname@example.org; Mary Longcore – email@example.com), or Susan Curtis (353-0817; Susan.Curtis@ht.msu.edu) know if you need additional assistance.
- Michael Zaroukian , MD, PhD
©2009 Michigan State University Board of Trustees. East Lansing MI 48824. MSU is an equal-opportunity institution.