Healthcare is about care of the patient. Physicians, nurses, house staff, ancillary-service providers, hospitals and nursing homes are all focused on maintaining a patient's healthy state, preventing disease, relieving suffering and, hopefully, returning the patient to a comfortable, useful life.
In recognition and support of this, we at Evanston (Ill.) Northwestern Healthcare are revising our patient-care documentation, ordering, resulting and registration process. The central belief motivating our change is that patient care will be enhanced through improving information, reducing duplication and delay, and minimizing the risk of providing incomplete or suboptimal care through inadvertence or incomplete data.
Evanston Northwestern has connected its three hospitals and 550 employed physicians of the Evanston Northwestern Medical Group via a community-based electronic medical-records system from Epic Systems Corp., a project that earned Evanston Northwestern the 2004 Nicholas E. Davies Award from the Health Information and Management Systems Society.
We also are creating a community of care by offering participation in this EMR to the 1,100 community physicians affiliated with Evanston Northwestern.
Affiliated physicians are offered the complete ambulatory EMR for the functions of registering, scheduling, documenting encounters, ordering, reviewing results, communicating with other physicians and patient billing, as well as for secure patient communication.
This transition from a traditional paper record to an integrated, community-based EMR is a tremendous change for practices, requiring an investment in resources, energy, time and a change of well-honed efficient behavior. What are the inducements to undertaking this change?
- Immediate access to complete, current and legible information on patients.
- Facilitated tracking and documentation of result review and patient communication about results.
- Facilitated sharing of information among caregivers in a multiprovider environment to create medical practice at the speed of thought, not the speed of paper.
- Access to an integrated practice-management tool that is driven by the clinical-care tool.
- Participation in an information community that patients perceive as beneficial.
- Access to best-practice alerts and educational information as vetted by a quality-improvement committee.
- Improved coding compliance for documentation and billing, resulting in cleaner claims and a reduced number of days in accounts receivable.
- Reduction/elimination of transcription costs.
- Malpractice premium reduction based on EMR use.
Adoption of this system brings along with it the only integrated ambulatory/inpatient clinical record.
For an investment equal to that required for a sophisticated practice-management suite (See chart), practices can now participate in a "virtual medical group" without the burden of abandoning private-practice ownership.
Arnold Wagner Jr., M.D., is an OB/GYN with Obstetrical and Gynecological Associates of Evanston (Ill.), an independent five-physician group affiliated with Evanston Northwestern Healthcare. He is also the chairman of Evanston Northwestern's medical informatics committee.
