Here in Iowa, we like to get going early. That's particularly the case with my hospital.
We started our EHR journey in 2004. We came right out of the blocks with point of care documentation, bar code medication administration, and information systems for pharmacy, lab, radiology, PACS and cardiography.
We did CPOE in 2008 before it was required for meaningful use. We interfaced every piece of lab equipment we own, storing all lab results only as structured data, and we built HL7 interfaces to the reference labs and pathologists so that is stored as data as well. We did med reconciliation, problem lists and all the rest as they became available. We built HL7 interfaces to our independent physician clinics and their disparate systems. We marched through the process of interfacing virtually all of our medical equipment including vital signs, perinatal systems, drug dispensing equipment, IV pumps and just about everything we could think of.
We started early and were ready for 5010 transactions on day one, and we believe we're ahead of the game with our ICD-10 journey, as well as with implementing speech recognition, tuning our workflows and using health information exchange.
Even so, there's much that causes us concern about the future. We are beginning to ask ourselves questions such as what will ACOs do to our environment? What are the implications–IT and otherwise–of patient-centered medical homes? How are we going to mine and analyze data to manage the health of the population? That's an issue because there are at least five EHRs in our service area, since the vast majority of our medical staff are independent and on EHR systems other than that used at our hospital. The five dialysis centers in our service area are also on a different EHR system.