Saturday, June 4, 2005

EMR promise and reality

It was standing room only in the POB-South classroom at Community General Hospital on May 27 when several presenters discussed the promise – and the reality – of electronic medical records (EMRs). The forum was organized by health care advisers to New York State Assembly Member Jeff Brown (121st Assembly District).

Dr. David Wormuth, a thoracic surgeon, opened the discussion by reviewing office-based medical record systems, such as the one he uses. This was followed by a discussion of hospital EMRs by Mitch Rozonkiewiecz, CGH vice president of information technology, and Chuck Fennel who has the same position at St. Joseph’s Hospital.

Mitch talked about the importance of linking separate CGH systems (such as radiology, pharmacy, and patient access) through a common “portal” that is easier for clinicians to use and that improves patient safety by reducing multiple data entries and patient look-ups. He also talked about a discussion by the Manufacturers’ Association of Central New York (MACNY) about possibly forming a regional health information network (RHIO). A RHIO would permit physician offices and hospitals with EMRs to exchange test results and other patient information, no matter where in our region a patient had tests.

Such connectivity is the promise of electronic medical records, although the discussion quickly focused on some barriers to that promise.

Several physicians in attendance talked about the difficulty of using EMRs that include lengthy narrations or formulaic sentences, making it time consuming to locate relevant information about a patient. Chuck Fennell said that, despite all the talk about records portability, “the health care industry is underserved because commercial products are not readily available for implementation in community hospitals.” There are some 300 vendors who provide systems with differing components, making it difficult for medical practices to select a vendor or commit to the cost of a system that might not survive all the market and regulatroy changes to come.

Mitch Rozonkiewiecz said that forming a local RHIO would be a formidable undertaking requiring the community to provide the “brains, the investment, and the standards for use.” Where, he asked, would the necessary resources come from?

One person attending the forum was Nasir Ali, the Chamber of Commerce vice president responsible for new venture development. He said the health care system is not a single process – it acts more like an ecosystem. He speculated the lack of a single, large customer makes it difficult for the information technology industry to focus on a single standard for connectivity. Mr. Ali suggested that the formation of RHIOs might provide a sufficiently large customer base to help the information technology industry develop the systems and standards necessary for connectivity, similar to that of the internet.

It was a fascinating discussion, full of promise and caution in equal measure.

Assemblyman Brown deserves thanks for arranging such a briefing on this important subject, and CGH was pleased to serve as host for the meeting.