St. Edward has a COW for EHR use

A patient at St. Edward Mercy Medical Center in Fort Smith should not be surprised if a COW is rolled into the room.

But this COW will not urge you to Eat mor Chikin or leave a mess. It will be a Computer On Wheels used by doctors, nurses and other caregivers to electronically monitor a patient stay from entrance to discharge to follow-up care.

St. Edward, which announced in September 2009 its new EPIC electronic health record system, held a system demonstration Thursday (Jan. 13) for the media.

The EPIC program is part of a $450 million systemwide install the St. Louis-based Sisters of Mercy Health System began to push in 2005. The Catholic healthcare company employs more than 29,000 and about 4,000 doctors in Arkansas, Louisiana, Mississippi, Missouri, Oklahoma and Texas. Hospital officials say the new system updates electronic health records for more than 2 million patients in the Mercy system. According to Mercy, less than 4% of hospitals nationwide have this level of EHR connectivity.

U.S. hospitals and doctors are under a federal mandate to install and use electronic health record (EHR) systems by 2015. The U.S. Centers for Medicare and Medicaid Services is managing a program to partially reimburse hospitals and doctors for EHR installation costs. That program, funded with $36 billion from the federal stimulus bill, will penalize — up to a 1% annual Medicare/Medicaid reimbursement reduction — doctors and hospitals not adopting approved EHR systems.

Of the about $19 billion in federal incentives to push electronic health record adoption, Mercy officials estimate they could capture $140 million over the next four to six years.

Crystal Hardy, a registered nurse and the informatics coordinator at St. Edward, used a COW on Thursday to click through the records of a mock patient during which several “alerts” were noted to ensure correct procedures were followed. For example, the system provides a “best practices alert” that reminds doctors and nurses what medicines or procedures may be best for a patient with a particular condition. Hardy noted that a piece of paper in the old charts would not provide the alert.

Among the system’s many features, it provides a patient and appropriate caregivers a discharge report summarizing the recent hospital visit, listing education sources or notes for the patient, follow-up care instructions and other vital information.

“And we keep all this in our system, so if the patient loses their report, we can quickly produce for them another copy,” Hardy said.

The system also allows doctors at Cooper Clinic to monitor a patient’s progress.

Dr. Larry Pearce, the EPIC accountability executive at St. Edward, said one of the best system attributes is the “lack of inconvenience” for patients. He said the system will keep better track of a patient’s history, so “each visit is not like a new visit” for the patient.

Also, the system tracks the use of patient records, with Pearce explaining that EPIC “is a good way to audit the use of patient records.” Perusing through a physical patient chart does not require a login, whereas access to electronic records uses a security system Pearce said is “very, very strict.”

According to a St. Edward press release, the 2009 American Recovery and Reinvestment Act (stimulus bill) provides incentives for hospitals and clinics to use an EHR system and demonstrate that it has “meaningful use” to those needing health care. The stimulus program requires EHR users to begin in April 2011 to prove their respective systems meet “Stage 1 of the meaningful use standards.”

Sparks Health System, also located in Fort Smith, installed an EHR system in stages, Sparks Marketing & Communications Director Donna Bragg said Aug. 17. Sparks, owned by Naples, Fla.-based Health Management Associates, uses what it calls a NexGen system for EHR.

“Our EHR system has been in use at all Sparks Clinic practices since October 2010. It continues to bring enhanced workflow and improved care for our patients. It is also assisting us in meeting the ‘meaningful use’ objectives set by the American Recovery and Reinvestment Act (ARRA),” Bragg said.

A Sisters of Mercy statement notes that 10 Mercy hospitals, including St. Edward in Fort Smith and Mercy of Northwest Arkansas in Rogers, will be among the first in the nation to provide this meaningful use verification during a 90 consecutive day validation period between April 1 through June 30.

Feeding the information system is a $60 million, 42,500-square-foot data center the Sisters of Mercy opened Aug. 30 in Washington, Mo. Officials say the center was built to be “a computer safe house, with the ability to transfer data equivalent to the entire contents of the Library of Congress in 6.5 seconds and withstand a F2 tornado.”

Hardy said entering the data and configuring the system for use at St. Edward has been an almost three-year process. Pearce said there was “a tremendous amount of data” on the old system that had to be transferred to the new system. He said Mercy’s satellite locations in the Fort Smith region will go live with EPIC “later this year.”