So far, the federal group in charge of laying out the requirements has said that hospitals must use an EMR for jobs such as tracking medications, accessing lab test results and recording patient care progress. At doctors' offices, computerized physician order entry systems must replace paper notes, while at hospitals, at least 10 percent of doctors' orders must go through that kind of electronic system. Insurance claims must be submitted electronically from an office, clinic or hospital. IT definitely has the ear of C-level health care executives, says John Stanley, SVP and CIO of Riverside Health System in Newport News, Va. The question is how to bend it.
Riverside started automating physician-office-based patient records 13 years ago, but the stimulus incentives have "put some more urgency into our journey," Stanley says. He runs two different electronic medical records systems. The principal user is Riverside Medical Group, a multispecialty group of close to 400 practitioners scattered over multiple market areas. Many physicians currently utilize CPOE and electronic prescribing capabilities. They also have an electronic record system in their Acute Care division, and the two systems exchange information. CPOE is currently being implemented across the various hospitals, starting with the hospitalists.
These sorts of technology projects are winning out over other business projects to get capital and the OK to hire, he says, estimating that the hospital will receive $20 million, subject to final regulations, from 2011 to 2015-a goodly sum for a nonprofit.
But for those who haven't begun automating, 2011 is going to come fast, says Aurelia Boyer, CIO of New York Presbyterian, a $3 billion, 2,200-bed healthcare provider.
"We started on this path way before Obama was elected," says Boyer, who is a registered nurse with an MBA. "If you haven't even started, you can't make it." She says her hospital could spend "tens of millions of dollars" when all is said and done. New York Presbyterian recently finished a Web portal based on Microsoft's HealthVault, where patients can access their health records, request appointments and pay bills. Crucial to opening up hospital data to patient access was the support of her C-level peers, she says. It's a major change in mind-set to unlock formerly sequestered, heavily guarded information that many care-givers consider their private domain. That change has to flow from the top, she explains, if staff are to accept new processes and the technology that supports them. "We believe this is the patient's data."
Steadfast Through Rough Patches