The new decade will see changes in health care technology.
Last year’s stimulus bill aimed to provide financial rewards to hospitals that have certain information technology developments, including electronic medical records, by 2015 and penalize those that do not. Duke has carried out an IT initiative for five years.
“[Duke] is well positioned to meet the requirements within the ‘meaningful use’ of EMR criteria with all of the IT applications they currently have,” said Mike Davis, executive vice president of the Healthcare Information and Management Systems Society Analytics, an organization that evaluates more than 5,200 hospitals on their IT developments.
Only seven health systems have received HIMSS’s highest distinction—stage seven—and among them is Stanford University Medical Center. Fifty-four, including John Hopkins Medicine and the Mayo Health System, have achieved stage six. Asif Ahmad, vice president for diagnostic services and chief information officer for Duke University Health System wrote in an e-mail that DUHS meets stage six criteria but has not considered becoming formally designated by HIMSS.
Typically, health systems that qualify for a stage six designation are formally invited to be designated by HIMSS, Davis said. But he declined to comment about whether DUHS had received an invitation. Davis added that he believes DUHS has a culture where IT is seen as an investment to better the quality of caregiving.
“I would not be afraid to go there and have any medical work done. And that’s a pretty serious statement from someone with the background that I have,” Davis said.
In addition to implementing EMR, DUHS exports the medical information of any patient treated at a clinic or hospital owned by Duke to a common viewer, called an e-browser. This allows physicians to have a comprehensive view of the patient even if he or she has never been treated at their care facility before, Ahmad said.
“We’ve demonstrated a microcosm of the health information exchange concept,” he said.
DUHS also uses EMR to make more information available to patients. Through the online Patient Portal, individuals treated at one of Duke’s medical centers can view test results, Associate Chief Information Officer Rafael Rodriguez said.
Ahmad said this viewing ability creates more consumer transparency.
With EMR data, DUHS has created a knowledge repository. The repository takes into account aggregate data from all care-giving interactions and uses statistical modeling to identify ways in which DUHS can improve its performance.
Hospital administrators hope to increase the amount of information contained in EMR. Currently, EMR includes information such as laboratory results, radiology images and physician orders, said Berit Jasion, associate chief information officer for technology, informatics and education services. Jasion said DUHS aims to make all information related to a patient’s care electronically available.
Kay Lytle, director of nursing informatics with Duke Health Technology Solutions, is working to make nursing documentation electronic. Currently, patient information collected by nurses, such as physical and psychosocial examinations, are carried out on paper everywhere but in the intensive care unit.
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