Geisinger Health System - On the leading edge of the Electronic Health Record revolution
Imagine:
an orthopedist sets a womans fractured arm 150 miles from her home clinic.
Within minutes, her local facility is able to view the clinical images, patient
records, and billing information. This access is extremely helpful when she
goes to her own doctor to get the cast removed six weeks later. And because
her records are accessible system-wide, it also makes it easier for her to get
invoice copies and make payments at the facility of her choice. That kind of
instant, secure access to medical information has been the holy grail of healthcare
for years. And with the federal governments recent mandate that all U.S. healthcare
providers implement Electronic Health Record (EHR) systems by 2015, the challenge
is even more daunting. Working with Vignette, Geisinger is already there.
The Challenge:
How to deal with mountains (and mountains) of records.
Like every healthcare provider, Geisingers business was originally conducted
on paper, microfiche and microfilm. In the mid-nineties, a new document system
was put in place to deal with the mountains of paper and files, but it soon
became clear that it lacked searchability and ease of use. When former veteran
FBI Computer Specialist, David Partsch, was brought on as IT Program Director
to deal with these growing difficulties, he immediately began pushing for a
new automated document management system. We estimated that savings from a
new automated system would pay for the project within 17 months. We also identified
almost $1.5 million in imminent costs that could be avoided in the first two
years, says Partsch. Geisingers legal department chimed in with its support,
projecting litigation savings of hundreds of thousands of dollars each year
based on improved record storage and retention.
The Goal:
A truly paperless office.
We wanted to get all of Geisinger paperless, declares Dave Macko, VP of IT.
We really wanted to go enterprise-wide, including HR, billing and insurance
records. We wanted to digitally store all the medical modalities including CT
scans, MRIs, nuclear medicine, general X-Rays, and ultrasounds. And most importantly,
he emphasizes, we wanted a single, integrated system. After an extensive search,
the unanimous choice was Vignette.
The Solution:
Getting down to business with Vignette.
The first hurdle: what to do with Geisingers 65 million pages of proprietary
images created in the old system. We were able to store and export everything
in its native format, notes Partsch.The long-range planto integrate all data
and recordswas also a critical consideration. The anticipated volume was huge;
medical records can be useful for well over a century and the Business Office
keeps account records for seven-to-ten years. We were able to develop full
integration with our EpicCare medical records system, explains Partsch Users
can retrieve images of patient record documents directly from within their Epic
User Interface. To the user, it is seamless and transparent.
The
Results:
For the Patients
Their histories, test results, and payments are instantly available in any of
the 50 Geisinger healthcare facilities. As backfiles grow over the years, physicians
will need only split seconds to retrieve generations of medical records when
tracking congenital conditions and propensities. The software organizes, assembles,
stores and circulates the information from Geisingers Billing, Claims Processing
system, Clinical systems, Medical Laboratory systems, Picture Archiving System,
Epic Systems Corp. patient medical records solution, Staffware workflow, and
its own document imaging and report management software. The Vignette solution
was also expanded to support the organizations HMO, the 260,000 subscriber
Geisinger Health Plan.
For the Staff
Today, more than 4000 staff members are online. Each department is different,
but all the solutions work through the Vignette infrastructure. The capabilities
are endless, Partsch projects. Pediatrics wanted to capture Microsoft Word
documents. The blood bank outputs electronic text files. Pathology needed to
automate laborious processes. Almost 400 different types of content are managed
with the one system.
For the Regulators
The Vignette solution has all the auditing we needed already in place, says
Partsch. The number of things that the technology logs is incredible. For any
function we do, theres an audit trail. Now physicians or departments create
their own document libraries, Macko adds. They store documents of any sort,
including photos, videos and lectures. Our Dermatology department alone had
10,000 old 35 mm. slides. These are being digitized for security and longevity
and then destroyed. But the images are available with a few keystrokes.
For the Business Office
In the business office, the improvement from the slow, original document imaging
system is evident in the smiles on workers faces.
In Conclusion:
Mountains made into molehills.
Implementing Electronic Health Records has led to a whole new level of patient
care for Geisinger. Patients get better and faster medical and business service.
Clinicians are able to more effectively do their jobs. The business offices
operate more efficiently. The effect is far-reaching, says Partsch.
