Ambulatory Electronic Medical Record and Shared Access (Illinois)
This project aimed to implement an ambulatory electronic medical record (EMR) across multiple and varied health care settings in a medically underserved region of east central Illinois. Sarah Bush Lincoln Health Center (SBLHC), a not-for-profit community health care corporation, served as the fiscal agent and lead organization for a collaborative partnership to deploy an ambulatory EMR. The goal of this implementation was to improve patient safety and assess provider and patient attitudes toward health information technology (IT) by: 1) providing shared access to patient records across hospital services, home health, hospice, physician practices, and non-hospital provider settings; and 2) integrating electronic tools for prescription orders and management of medications. Project partners included two private practice organizations and the Health Services Division of Eastern Illinois University, a regional, residential university. The purpose of this project was to offer providers and patients a seamless coordination of care across a continuum of services by sharing pertinent patient information between the emergency department, home health and hospice, family and internal medicine practitioners, and specialists throughout the rural community.
The ambulatory EMR, implemented at approximately one-third of the SBLHC practices by the end of 2009, provides a means to share a longitudinal medical record that contains, at a minimum, a patient problem list, medication list, allergies, radiology images and data, laboratory data, and a patient care plan. The long-term goals of the partnership are to:
- Successfully deploy an ambulatory EMR with shared access to patient records across hospital services, home health, hospice, and employed and independent physician practice settings.
- Use computerized provider order entry and clinical decision support systems to reduce medication errors and increase patient safety.
- Provide a method to utilize the EMR for data collection, analysis, and reporting of the number and types of medication errors and adverse events that occur.
The principal findings for the ambulatory EMR implementation show that both the emergency department and inpatient caregivers benefited from having access to the patients' ambulatory medication lists electronically. Overall, physicians, mid-level providers, and nursing staff in the SBLHC clinics believed that the system did not increase their productivity up front; however, the users will most likely appreciate efficiencies once the charts are more established. The users stated that they would prefer the system's shortcomings be enhanced rather than revert to their old processes.