Medical records go online at MidMichigan Health
The days of nurses coming to your bedside and flipping open your handwritten medical chart and doctors writing illegible prescriptions for tests and drugs are coming to an end at MidMichigan Medical Center Midland, and across the health system.
MERLIN, the internal name given to the electronic medical record project for MidMichigan Health, became operational Saturday at MidMichigan Medical Center Midland. Patients and guests to the hospital will notice greater quality of care and greater portability of their medical records.
A team of specialists from all four MidMichigan Health facilities in Midland, Gladwin, Clare and Alma have worked to install an electronic records system at the facilities during the past 19 months, according to Greg Rogers, president of MidMichigan Medical Center Midland and project co-sponsor.
It’s been six years since the medical facility began planning on changing to the new system and five years since the hospital installed SurgiNet, electronic records for the surgery unit.
“It’s been a long journey,” said Karen Calkins, who stayed on after retiring as the chief nursing officer to become a co-sponsor of the $50.1 million project with Rogers. Richard M. Reynolds, president of MidMichigan Health, is the executive sponsor of the EMR project.
Thousands of people at the four facilities have been involved.
“The whole health system has become the team, that’s how integrated we are,” said Sue Haley, the clinical project director.
The team began with 40 people, but as the months went by, experts from across the medical spectrum were brought in, according to Bob Harris, project technical director.
“Sometimes we’d have as many as 80 people working on the project,” he said.
The team has been working 12-hour days, six to seven days a week since October 2009. Haley said more than 398,000 man-hours, what she termed a conservative estimate, have been directed toward the project during that time, not counting the involvement of the Kansas City-based Cerner Corp., the vendor of the software, and Deloitte Consulting, both partners in the project.
“We look at this as a clinical transformation process. It’s about people and changing our processes and not just enabling IT software,” Calkins said. “We did a discovery phase and we spent a lot of time looking at current practices and worked with experts to determine what is best practice.
“Our guiding principles were about patient safety and quality and improving patient outcomes,” she said.
“Part of our mission is to improve the quality of life of the people in the communities we serve and it was a strategic focus for us to do this,” Rogers said. “This is a big step in that direction. This is the most complex project we’ve ever done at MidMichigan Health.”
Although Midland is the first facility in the organization to come on-line, all four facilities eventually will do away with the clinical charts and paper records which have been a part of hospitals and health care for as long as people can remember.
Harris said programs such as MERLIN, which stands for “multidisciplinary electronic record linking information across the network,” are becoming standard practice of care in the medical field.
“We are not on the tip of the spear. We’ve let other people spend a lot of R&D money to sort it out,” he said.
He said Cerner is one of the top two electronic medical record providers in the nation.
Rogers said, “Some people say the oldest system we have at the hospital is the system that we use to document. Some articles would suggest that that system is over 100 years old, and relatively unchanged. This is a quantum leap forward.”
At 10 p.m. Friday night, the hospital shut down all its old systems and began converting over to the new one. That task involved posting all the information on the old system to the new one, including discharging patients and readmitting them to the Cerner system, re-entering all patient prescriptions, checking all interfaces, and reentering all physician information.
A team of 34 people worked throughout the night Friday in the main command center, eight to 10 people were in the physician command center, eight people were working on interface coordination issues (making sure the different systems already in the hospital can talk to one another) and 14 people in the pharmacy group, the group with the greatest workload. All prescriptions will be entered by a pharmacist and checked by a nurse.
Although there is a lot of other work — including reregistering about 12,000 outpatients — Calkins said, “We’re very focused on maintaining the integrity of the (medication) orders as they cross from our current system to our live Cerner system, so that is where our focus has been.”
People are very excited, she said. “We’ve had a lot of volunteers. It’s not like we’ve had to twist people’s arms to do it.”
Patients will notice that information they give to hospital personnel will be entered into a computer system but it is what they might not even think about, or that they cannot see, that will be important to them.
For the most part, patients coming into the hospital will only have to provide information once, and that information will follow the patient from admitting, to ER, to surgery, to rehabilitation, to the pharmacy and to all the other places associated with the facility. In addition, the electronic record will keep track of chronic conditions, such as asthma or diabetes, that might affect prescription usage, compare prescribed medicines for compatibility and show hospital personnel a history of drug usage so that better decisions can be made.
Some questions might be re-asked to verify a person’s identification, but the basic information will be there, said Harris.
Haley said that having to give repeat answers to different members of a hospital team when patients are moved to different levels of care can irk some patients.
“Probably one of the most frustrating points that patients consistently speak about is the number of times they have to repeat information, so from the time a person has to see a physician with devastating diagnosis to the time that they come in for surgery, in a week’s time, in our current environment, pre-EMR, the same information as many as 15 times. Now, they will be giving that information once and it will then flow to the next caregiver. It will be a huge satisfied for our patients.”
Harris also noted dispensing medications will be safer under the new system. “Every medication we give will be bar coded, so we know what the drug is. Each patient will be bar coded and each caregiver will be bar coded.”
Then the medicine and patient will be scanned before each dose is administered and the nurse will get a confirmation that the medicine is “the correct drug, correct route, correct time, correct dose and correct patient.”
Doctors will be notified immediately if there is an error in dispensing medicines to one of their patients.
The EMR transition team has been working with a physician’s advisory group, headed by Dr. Pankaj Jandwani, which has been instrumental in making decisions involving the medical staff as well as in helping with the training.
“The physicians throughout MidMichigan Health have been outstanding,” Rogers noted.
Rogers pointed out two other improvements for both staff and patients. With written records, he noted, only one person at a time can look at a chart. All personnel taking care of a patient can look at the record electronically at the same time.
In addition, doctors can call up records from wherever they are, including at home, he said.
Hospital officials also addressed the security issue. Rogers said EMR are more secure than paper.
“Right now, who knows who is looking at the paper record. With this there is a trail of who has access.”
With the Cerner system, only people authorized by the hospital’s full-time security officer will be allowed access — at levels determined by the security individual — and the system is compliant with the federal Health Insurance Portability and Accountability Act.
“I can’t go in in my role and look at patient records … there’s no need for me,” Rogers said. “It’s more secure because you can control who has access.”
Harris said there are a lot of plug-ins and upgrades to the Cerner module that MidMichigan Health will be pursuing in the future. He also said Cerner, which is hosting program at its data site in Kansas City, has the redundancy needed for a hospital, which needs to be running all the time.
Penny Daniels, who was the EMR communications lead on the project, said meetings have been ongoing over the course of the project to ensure that employees had a chance to be heard, and to express their feelings about the change that was coming. And they’ve done some pretty creative things — such as the contest to name the transition MERLIN and working out of MidMichigan Medical Center Gratiot, where they were greeted warmly by the staff there.
Haley said that while the name served its purpose of helping to bring people from four units together during the long hours and long days, its now becoming the electronic medical records.”
“MERLIN is fading into the woodwork,” she said.
Harris said major suppliers of software for electronic medical records are working toward a continuity of care record that will allow cross platform transfer of medical information to different hospitals.
Rogers credited a lot of people for bringing the project on-line.
“The team has been outstanding,” he said.
Pharmacist shares his family’s triumphs, tragedies in novel
Dr. Luke A.M. Brown classifies his novel ‘The Non-Silence of the LAMB: Adult Contemporary Version’ (ISBN 1456588001) as a work of reality-fiction. While it is loosely based on certain dramatic events in his life, the book introduces readers to a Caribbean-American single mother’s immigration struggles and triumphs.
Essie, an orphan, has always dreamt of a better life. When she’s placed with a family in the Jamaican countryside, they treat her horribly and even resort to abusing her. She grows up to bear eight children without the assistance of the fathers to help raise them. She almost gives up hope until she decides to move to the United States, thus restoring her drive to live.
As Essie’s son, Brown draws upon his own life for the inspiration behind this novel. From a young age, the author admired his mother’s calm and confident demeanor and her will to plow ahead even when the large family had little to eat.
After losing his mother, two sisters and nephew within three years, Brown realized that many of his tragedies taught him some of life’s most important lessons. He was inspired to spread awareness of HIV and the severe consequences of the disease after losing his sister to it. Brown combines love, family feuds, success and heartbreak in ‘The Non-Silence of the LAMB’ to entertain adult readers.
‘The Non-Silence of the LAMB: Adult Contemporary Version’ is available for sale online at Amazon.comand other channels.
COLUMN: Patients play a key role in medication safety
Recently, health-care providers recognized National Patient Safety Awareness Week.
At Riverview Hospital Association, we strive to maintain a safe environment for our patients and community every day. Our physicians, nurses, pharmacists and technicians are members of each patient’s health care team and play a vital role ensuring that care is provided in a safe manner. Patients and families also have an important role to play in ensuring their own safety.
At Riverview Hospital, we provide our patients with “Partners in Safety” information, listing all of the things that a patient and his or her family can do to partner with us to provide safe care. While there are numerous things that are done to promote safety in the hospital and clinics, we would like to highlight one of the most important: Medication lists.
Patients play a key role in medication safety. Medication safety means that you will receive the medication prescribed to you at the right time and in the right way. Our physicians, nurses, pharmacists and technicians welcome your involvement. You can be a “Partner in Safety” by making a list of your current medications. The list should include the name of the medication, the dose and the frequency with which you take the medication. You should bring this list with you every time you seek medical care (physician’s office, pharmacy, emergency room and in the hospital).
When you seek medical care, the list will be reviewed with you, and the physician will determine which medications should be continued or discontinued. This is called “medication reconciliation.” Through medication reconciliation, you are being asked to learn about the medications you are taking, why and when you should take them and their potential side effects.
If you or a family member are unable to make a medication list, please bring all of your medications — including over-the-counter drugs, herbs, vitamins and other dietary supplements — in their original containers when you seek medical care. Your health care provider will assist you in making a medication list that you can carry with you.