2012-08-29 / Features

Crowley Supports Modernized Medical Record System

Congressmember Joe Crowley views the newly modernized medical record system. Congressmember Joe Crowley views the newly modernized medical record system. Senior Vice-President of Queens Health Network Dr. Ann Sullivan welcomed and recognized Congressmember Joseph Crowley for his support of the HIT Provisions of the American Recovery and Reinvestment Act (ARRA).

Sullivan, in introducing the congressmember on August 21, said, “We have Congressman Crowley to thank for championing this key legislative initiative. As a result of the HIT provisions of ARRA, the entire HHC system is slated to receive up to $200 million, which will be used to modernize and expand our electronic medical record and IT infrastructure.”

Last month, the federal government certified that Elmhurst Hospital Center’s (EHC) use of the electronic health record and information technology, at EHC and all HHC Hospitals, is so pervasive and well integrated into patient care that they have achieved “meaningful use status”. As a result of this and continuing compliance over the coming years, it is expected that Elmhurst Hospital Center will receive approximately $14.4 million in federal funds, which will allow Elmhurst Hospital Center to continue to invest in their information technology efforts. These payments are a direct result of the Health Information Technology (HIT) provisions of the American Recovery and Reinvestment Act of 2009 (ARRA)- the Stimulus bill.

Crowley said, “With this system in place residents of New York will be able to travel anywhere in the country and their medical records would be accessible to them and medical professionals while still maintaining confidentiality.”

In order to be certified for meaningful use it took more than simply installing an electronic medical record and declaring success. For instance, at Elmhurst:

•100 percent of inpatient medication orders are placed in the electronic record. As a result, we can automatically check for potentially dangerous medication interactions, confirm that there are no allergies to the ordered medication, andafirm that the dosage is within the expected range. Meaningful use dictates a 30 percent minimum for electronic medication orders. Elmhurst is at 100 percent.

•The safety checks in the record can only work if the clinical information has been entered.

•To be certified as achieving Meaningful Use 80 percent of the medical records have to have an up-to-date problem list. Elmhurst is operating at about 94 percent (What is a “problem” list?)

•Meaningful use required that 80 percent of the medical records have the patients’ allergies recorded. Elmhurst is at 99 percent.

•Meaningful use required that 80 percent of the patient medical records list prescribed medications. Elmhurst is at 100 percent.

HHC has electronic medical records across all settings, from in-patient units to ambulatory care clinics. HHC’s electronic medical records allow us to receive program alerts and provide strategically placed data fields that have helped guide evidencebased care. Electronic medical records have also helped facilitate coordination across the continuum of care. The EMR also has embedded depression screening aids, asthma action plans, Coumadin dosing safeguards, and deep-vein thrombosis prophylaxis guides, among other meaningful functionality. A data warehouse populated from the EMR has allowed HHC to run electronic chronic disease registries that have proven to be an effective tool in helping clinicians better manage diabetes and hypertension. As a result, all HHC facilities now qualify under the National Committee for Quality Assurance’s (NCQA) Diabetes Recognition Program as excellent providers of diabetes care.

Another aspect of meaningful use is that hospitals not only have to demonstrate they can use information within their facilities, but that it be made available where the patient needs it, even if care is provided elsewhere in the community. To that end Elmhurst was a founding stakeholder of the

Interboro Regional

Health Information

Exchange. Through the Interboro RHIO, Elmhurst has the capacity to share patient information with not only several other HHC facilities, but with hundreds of private doctor offices, as well as with some neighboring voluntary hospitals. This capacity will expand in the coming months and help us improve the continuity of our patients’ care and maintain our eligibility for ARRA support.

Director of Medical Informatics Dr. Glenn Martin explained how we trace a patient from entering until leaving the hospital. The patient’s history will all be recorded including medication orders and allergies. The system includes depression screenings, clot tracking and sepsis. Additionally, he states that the EMR system, which includes electronic order entry to prevent drug errors, built-in computer prompts to guide best-practice care and provides ways to use data to improve health outcomes and better patient safety.

Director of Cardiology Dr. David Rubinstein demonstrated how the EMR system works and showed views of a test example of a cardiac angiogram which can be electronically transmitted throughout the country.

Sullivan continued, “Over a decade ago the Queen’s Health Network earned the coveted Nicholas E. Davies Award from the Healthcare Information and Management Systems Society for excellence in using electronic medical records to improve healthcare delivery. It is gratifying to know we remain in the forefront of using technology to improve patient care. This federal assistance will work to support our continuing efforts in this vital arena and we are thankful to the congressman for his continuing support.”

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