Hospital taking medical records online

MIDDLEBURY — Porter Medical Center is making slow and steady progress toward a massive $4.4 million project to bring the hospital’s information system and medical records into the 21st century.
Though the finished project is still more than two years out and the hospital is waiting on state approval to move forward, hospital administrators are confident that the new information technology could improve the quality of care at the hospital.
The system would transition medical records from paper files to online databanks. Instead of pulling a medical file from a physical library, Porter doctors — and, possibly, doctors around the state — would be able to access a patient’s record at the click of a button. The medical records would only be one part of the new system, though; the pharmacy, laboratory, operating and emergency rooms, and many more parts of the hospital would also be linked through the new network.
“It is imperative that Porter, along with other hospitals, implement electronic medical record systems,” said Porter spokesman Ron Hallman. “The question has never been whether or not we needed to do this. The question has been which system is best.”
Given that Porter has a hospital in Middlebury, physician practices scattered throughout Addison County, and a laboratory and pharmacy that all work together, Hallman that it can be challenging at times to make sure that information is shared in the most efficient way possible. A new IT system, he thinks, would change all that. Sharing clinical information would not only mean that patients would have results more quickly, but that hospitals in general could operate more efficiently.
The hospital filed a “certificate of need” with the state this month. The certificate is required for any project a hospital wishes to undertake that costs more than $3 million. If all goes smoothly, state regulators could approve the certificate by the end of March. Next, the hospital will need to meet with the Public Oversight Commission. Porter Vice President of Finance Duncan Brines said that, realistically, it could be June before the hospital is ready to start on the bulk of the electronic medical records project.
So far, the project has been broken down into two phases. The hospital is moving ahead with behind-the-scenes work to bring the hospital’s general ledger, human resources and payroll, and budgeting operations online.
If the state OKs the second, more expensive phase, the hospital will move on to the next, much more extensive step: building a system that would encompass medical records, patient records, pharmacy and laboratory operations, operating room management, and much more.
All in all, the entire project is expected to take more than two years to finish. The “go live” dates for various chunks of the project are staggered from January 2011 to September 2012.
Porter has decided to hire Medical Information Technology Inc., known as MEDITECH, to help the hospital design and build the complicated software that will power the new information system. Porter selected MEDITECH from 13 different IT vendors. Brines said the Westwood, Mass.-based company is the most popular among small and medium-sized hospitals, and will also be used by Northwestern Medical Center in St. Albans.
Though the system isn’t identical to ones being put in place at other hospitals around Vermont, Brines said that Porter’s medical records will be compatible at some level with other hospitals’ IT networks. On the statewide level, the nonprofit organization Vermont Information Technology Leaders is leading the charge to build a system that would retrieve medical records from various hospitals.
Of course, the switch to electronic medical records won’t be instantaneous. Twenty years from now, Brines said, it might well be that hospitals don’t include paper records of any type. In the short term, though, he envisions paper and electronic records existing side-by-side during a period of transition.
Brines said that patients might notice some changes, when electronic medical records are finally put in place. He’s spoken with patients from other hospitals that have already made the switch, and some have expressed frustration that personable doctors who once made eye contact with patients now devoted most of their attention to a computer screen.
But he pointed out that there will be many tangible benefits. Doctors should be able to pull up information about patients more quickly, and results from lab tests could be passed from one end of the hospital to the other simultaneously.
Brines is reluctant, though, to guarantee that the switch could save the hospital money in the long run.
“There are all kinds of experts at the state and national level that swear that this will save money,” Brines said. These experts say that better coordination of care, and less paperwork, will translate into savings.
But Brines said the most recent studies show that while new IT systems could generate more revenue by making sure tests and procedures don’t fall through the billing cracks, they’re not anticipated to make for significant savings.
“I’d be the last person to try to guarantee savings,” Brines said. “I just don’t know. Time will tell.”
There are other hurdles, too. The hospital — and in fact, the entire medical information technology industry — are busy working to find a balance between making records accessible and patient privacy. A doctor might want to pull up a patient’s file on a smart phone, Brines said, but the hospital needs to find ways to encrypt that information so it can’t be downloaded by anyone without explicit permission.
It’s something of a catch-22, he said.
“We all want the easy access but we also want security,” Brines said.
There’s another possible hiccup for Porter, too: If the Legislature this year decides to put spending caps in place for hospitals, those cost containment measures could make big investments in information technology unfeasible.
Some members of the Legislature are considering writing an exception into cost containment laws that would create a loophole for IT investments, but Brines said it’s too early to know how talks in Montpelier might play out for the hospital.
In the meantime, Porter is focusing on its first priority: completing the first stage of the IT project. They’ll begin work on the first phase this summer, and hope to take this part of the system live next January.
If the hospital has to push back further improvements, the second stage of the IT project could wait.
“It’s like building a home,” Brines said. “You have to have the foundation. This first phase is the foundation, and then hopefully, everything else will happen.”
Kathryn Flagg is at [email protected].

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