New records technology pushes Alliance ahead

In Healdsburg and Windsor, Alliance Medical Center is adopting
state-of-the-art medical record technology designed to enhance
patient care and facilitate communication among providers.
“To be a patient-centered medical home, you have to have
electronic records. We have to be on that train—if we aren’t, we
are going to be hurting,” said Jack Neureuter, CEO of Alliance
Medical Center.
Alliance is implementing both Electronic Health Records (EHR)
and Health Information Exchange (HIE).
EHR will shift medical records within the center to a
computer-based system, enabling physicians and nurses to call up
medical records with the touch of a button instead of a trip to the
records room. The transition to EHR will save the center a
considerable amount of space: currently, paper records fill an
entire front room of the Healdsburg facility, with more records
tucked away in additional rooms or storage space. Those papers will
not disappear immediately: paper medical records will be retained
for 7 years prior to disposal, and children’s records will be
retained for 7 years after the patient turns 21.
While EHR focuses on operations within the center, HIE focuses
on communication between different providers. HIE will enable the
center to electronically receive and transmit patient
information—such as lab results or pertinent history—from other
facilities.
With HIE, staff said, privacy and client protection is
paramount.
“The state has gone above and beyond HIPAA. We are the leaders
in our field,” said Will Ross, project manager for Redwood MedNet,
Alliance’s technology partner for HIE.
“We are meeting some resistance from other facilities,” Mark
Street, technology officer for Alliance, noted. “We’re going to
have to be trailblazers on this, and show them the tremendous
efficiencies to be gained.”
Resistance stemmed not from fear of information leakage but from
the required shift in work flow.
“This does represent a work flow change for someone who is a
professional, and has optimized their workplace as it is, so there
will be some adjustment,” Ross added. “But a lot of health care
involves hunting around for the information required to make the
decision, instead of deciding. The purpose of MedNet is to make it
easier for the caregivers.”
HIE is already functioning at Alliance; the center can currently
receive patient lab results from LabCorp, Quest Diagnostics,
Healdsburg District Hospital, and Santa Rosa Imaging.
EHR is still in the early phase of implementation. Preliminary
training for EHR has begun, but the system will not go live until
next year. Alliance plans to implement the EHR system first at the
Windsor facility in February of 2011. The Healdsburg facility will
follow suit in April or May, and the transition is expected to be
complete by July of 2011.
Although ultimately both systems aim to save money and increase
efficiency, EHR will require a considerable initial investment.
“The rule of thumb is that we lose three dollars for every
dollar we spend on the system,” Neureuter said.
That cost is associated with the retraining of staff. Typically,
immediately after implementation, the rate of service will slow
from 3 patients per hour to 1 patient per hour.
“They say you lose 80 percent productivity the first month, 60
percent the second, then 40 percent, then 20 percent, and by the
end of the fourth month you’re back to normal,” Neureuter said.
“We’re hoping to cut that training time to two months.”
The cost of lost productivity, combined with an approximate $1
million system, is a steep price to pay at a time when donations
are slow and uncompensated care costs are higher than ever. But the
leadership at Alliance is weighing short-term costs with long-term
benefits.
“It’s so important, because medical records are the quality of
care for the patient,” Neureuter said.
On Friday, Congressman Mike Thompson visited the Healdsburg
facility to see a demonstration of the new system. Thompson took
the opportunity to have a brief dialogue with Alliance leaders
about healthcare.
“I think that people need to know that health care reform is
good stuff. We spent $70 million on uncompensated care in District
1 last year. That’s the new face of Medical – an unemployed
breadwinner who can’t afford COBRA,” Thompson said.