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Electronic health records on way

Throughout St. Charles system


by: HOLLY M. GILL - Gay Flegel, R.N., supervisor of the obstetrics department at St. Charles Madras, demonstrates how she will be able to check electronic medical records at a 'work station on wheels' when the records go live Aug. 26. Flegel is holding 2-day-old Rylynn Gray.St. Charles Madras will join the digital age on Aug. 26, when its health records are converted to an electronic format.

The long-awaited change to electronic health records was one of several key reasons cited for the Jan. 1 transfer of Mountain View Hospital's assets to St. Charles Health System. Before the asset transfer, the hospital was looking at a cost of $3.5 million to make the required conversion to electronic health records.

"We've been working on it for over a year," said Jeanie Gentry, CEO at St. Charles Madras, noting that all four hospitals in St. Charles Health System — St. Charles Bend, Redmond and Madras, and Pioneer Memorial Hospital in Prineville — have had staff working on the change.

"It's been a real team, collaborative effort," said Gentry, who had researched the costs of converting the hospital's records before the asset transfer.

"It was going to be four times as much to do it on our own as in conjunction with St. Charles," she explained. "We couldn't afford to do it on our own, and we didn't have the IT (information technology) people to do it."

Both St. Charles Bend and St. Charles Redmond have been on an electronic medical record system — McKesson's Horizon — for the past few years, but decided to convert to the more user-friendly Paragon system, which is also made by the same vendor, she said.

"Bend and Redmond are switching to Paragon, and Madras and Prineville, from paper to Paragon," said Gentry.

The new electronic records will only go back about a year, but key information will be scanned in. "We'll scan whatever we need to, to care for a patient," she said, adding, "It takes resources to scan records, so we only want to scan things that are meaningful to the patient."

When someone visits the hospital, "we'll start making a new record that will be all electronic," she said.

The records will be highly protected and backed up in multiple locations, including the main servers in BendBroadband's big data center.

The hospital is only required to keep most records about 10 years, but that hasn't been the practice locally. "Here in Madras, we've kept them much longer than that," said Gentry.

Electronic medical records are a federal requirement for hospitals and doctor offices by 2015, under the Affordable Care Act, passed in 2010.

With the implementation of the electronic medical records, the hospital must also meet certain "meaningful use" criteria. The system must collect demographic information, such as whether or not a person is a smoker, as well as clinical information, such as information about diabetic patients.

Under the current system, the hospital has no way to manage the diabetic population and figure out whether or not it is improving the population's health, she noted. The clinical information contained in the electronic record will help the hospital make those determinations.

"This is going to mean better patient care," she said. "Doctors make decisions about your care based on information; if they don't have information, they can't make the best decision."

"They want us to improve the health of the people we serve, not just take care of sick people," said Gentry. "Even if it wasn't a requirement, we would probably still need to do this. It's just better care."

Both the Warm Springs Health and Wellness Center and Mosaic Medical are already using electronic systems, but Madras Medical Group hasn't yet converted its records.

Repairs ongoing; design work to begin

Although the conversion to electronic medical records is the biggest project at the hospital this year, St. Charles Health System has been providing other assistance to the hospital as part of the agreement signed last year.

"Besides the computer system, we have had help on projects we needed to get done — safety code violations on the building," said Gentry.

St. Charles, which is preparing to begin construction next year on a new hospital in Prineville, will also be moving forward with early design work for expansion and renovation at St. Charles Madras, she said.

In January 2012, the Mountain View Hospital District went out to bid on a $22.4 million construction project, but the bids came back too high for the third time in as many years.

The hospital decided to scale back the project, but by summertime, the project was off the table. Because of changes in reimbursement from Medicaid, Medicare and Indian Health Services, as well as the required conversion to electronic records, the hospital started talks with St. Charles about the asset transfer.

The hospital still has the same needs it had before the asset transfer, Gentry noted, and will be able to make use of the $1.5 million previously spent on architectural work.

"I don't think it will take as long as normal, because we've already done so much work," she said.



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