A recent article in the Washington Post cited an analysis of electronic medical records that found they had improved efficiency and patient care "only marginally," thanks to the fact that doctors didn't embrace the idea and that, rather like the snake pit of cell phone chargers we're all familiar with, the many brands of software didn't necessarily communicate with other brands.
Arkansas's State Health Alliance for Records Exchange (SHARE), which will be able to translate data from any electronic record vendor, should take care of that inability to communicate and allow doctors across Arkansas to share, in a secure system, patient information with each other, hospitals and pharmacies.
That means, for example, a clinic referring a patient to a hospital can immediately transfer his medical history — tests performed, results, prescriptions, diagnoses — thus reducing redundancy (and costs of treatment).
It also means the North Arkansas Regional Medical Center in Harrison, the first medical system to go online, can use SHARE to convey information instantaneously to doctors within its own system, which is affiliated with clinics in Jasper, Marshall, Lead Hill and Harrison, as well as health care providers who are certified to access SHARE. There is no waiting on a fax at the end of the day to get lab results.
NARM Chief Executive Officer Vince Leist said his hospital was working with a consultant on creating an electronic database for clinics to communicate with the hospital when he learned about SHARE from Ray Scott, Arkansas health information technology coordinator.
There are costs associated with going from paper charts and fax machines to electronic records, Leist said. "Any time an industry evolves it costs in all aspects," he said, including labor and dollars. But it makes sense.
The University of Arkansas for Medical Sciences and Jefferson Regional Hospital in Pine Bluff will also join SHARE; UAMS will start sending data to SHARE in February and Jefferson within 45 to 60 days, said Christy Williams of the health information technology office. Hospitals and doctors who don't yet have the technology to "onboard" information with SHARE may still "break the glass," as Clinical Informatics Director Matthew Sakalosky said, to obtain patient records held in SHARE's database as long as they have been approved by SHARE. For example, if a patient seen at a clinic affiliated with NARM appears in the UAMS emergency room and is unable to provide information, UAMS will be able to go to SHARE for the information. The process complies with Health Information Portability and Accountability Act (HIPAA) rules.
"We are somewhere in the 1970s for how inefficient we were in gathering clinical information," Scott said. Scott used UAMS' obstetric department as an example of how SHARE will bring efficiency and, it's hoped, good patient outcomes: The "nationally recognized program with high risk pregnancies," Scott said, gets "literally thousands of faxes a month from ob-gyns all over the state, which is not a very efficient and effective way for crucial clinical information to get transferred."
The push for health information technology sharing systems began in the last two years of the George W. Bush administration, Scott said, but was unfunded until the American Recovery and Reinvestment Act was passed in 2009 under President Obama. That act provides for some reimbursement to participants in the Medicare and Medicaid system that make their records electronic.
Scott said the system will make it possible for specialists who formerly operated in what he called information "silos" to share information about a patient who sees several doctors for various conditions. He said that in his travels in the state to present information on SHARE he was "stunned at the number of people who just assume this is already happening ... they don't understand their doctors are not talking to each other."
Patients can opt out of the system, and taking part in SHARE is voluntary for health providers.
But Scott noted how SHARE will help track doctor performance, part of Arkansas's Payment Improvement Initiative that will offer incentive payments to doctors who see patients under Medicare and Medicaid for efficient medical care.
Scott said it's "very early in the game" for the SHARE system. NARM, for example, has only 174 hospital beds and employs only 60 physicians. Scott's goal is to connect to 20 hospital-affiliated and critical-access clinics — those in rural areas — this year. He's currently working with "at least eight" other provider systems. It should take five to seven years for the system to include most Arkansas health providers. "Our goal is to remove clipboards from every waiting room in every physician's office," he said.
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