One System of Care, One Electronic Chart

One System of Care, One Electronic Chart

Jennifer Gholson (Regional Health, USA) and Heidi Tennyson (Regional Health, USA)
DOI: 10.4018/978-1-4666-6339-8.ch055
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Abstract

Regional Health made a commitment as part of quality and patient safety initiatives to have an electronic health record before the federal government developed the concept of “meaningful use.” The “One System of Care, One Electronic Chart” concept was a long-term goal of their organization, accomplished through electronically sharing a patient's medical record among Regional Health's five hospitals and other area health care facilities. Implementing a hybrid electronic record using a scanning and archiving application was the first step toward the long-term goal of an electronic health record. The project was successfully achieved despite many challenges, including some limited resources and physician concerns.
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Setting The Stage

Prior to the start of the scanning and archiving project, Regional Health’s main Health Care Information System (HCIS) was essentially a character-based system that had been in use at RCRH since 1983. By 2006, all five hospitals within Regional Health (RH) had been using this platform in an integrated fashion for at least a year; however, each hospital was in different stages of implementation. Because RCRH had been fully utilizing the new HCIS the longest, they were more proficient and advanced with its functionality.

Prior to the scanning project, each hospital used different methods for medical record retention. Even though state laws allowed for destruction of records (Brodnik, McCain, Rinehart-Thompson, & Reynolds, 2009), most of the hospitals were either retaining all their paper records or used another method for permanent storage, such as microfilm or standalone document imaging systems. Despite these efforts, the hospitals found they were running out of space for paper chart storage. By 2004, the RCRH Health Information Management Director submitted a formal request to look for an electronic document management solution. A business case was written and originally approved in the fall of 2005 to purchase and implement the scanning and archiving module that was part of the platform being used at the time.

A few months after the project’s approval, RH’s plans to develop an Electronic Medical Record (EMR) had an impact on the project. A key step in the development of an EMR was the conversions of the core HCIS to a version that had a better (more like Windows) user interface. Because of the large scope of the conversion project, the scanning project was temporarily halted when it was learned that any scanning build done in the old system would have to be completely rebuilt in the new HCIS.

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