Digital health records part of present, future

Margarita Cambest

Visit any doctor’s office or medical center today and some changes — modern equipment, new waiting room furniture — jump right out. But when you get into the exam room it’s computer-assisted patient charts and medicine that take center stage.

The Affordable Care Act required electronic health records be adopted by U.S. physicians by 2012. Memorial Hospital, WellSpan York Hospital and Hanover Hospital all use some sort of electronic health record.

Sometimes controversial, the digital records replace traditional paper charts, allowing doctors to track a patient’s medical history and prescribe medication from computers in hopes of making care more efficient. By decreasing the amount of time spent on administrative tasks and reducing medical errors, doctors would have more time to spend with their patients.

However too much time on a computer can take away from the patient-doctor relationship if not implemented correctly, said Dr. Ken Woerthwein, a retired local physician

“The more time that is spent by that primary care provider in trying to review and retrieve data, the less time you have to verbally interact and examine the patient,” he said.

Local retired physician Dr. Ken Woerthwein is a big believer in electronic medical records but says “the more time that is spent by that primary care provider in trying to review and retrieve data, the less time you have to verbally interact and examine the patient.”  Monday, Nov. 7, 2016. John A. Pavoncello photo

Woerthwein spent more than 30 years in private practice, retiring from family medicine just as WellSpan Health implemented the early stages of electronic charts at its physician offices.

Still, he said he’s a big believer in electronic medical records. In the months just before leaving his practice he spent as much as three hours a day carefully transferring patient information from paper to digital. However, he said he could see how additional training or the help of another employee to serve as a scribe would help doctors focus better on their patient.

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“With paperwork, you would lose important data. Imaging, diagnoses ... they would get lost in the paper trail," Woerthwein said. "As long as it's entered in the digital chart, it’s there.”

Initial use: WellSpan Health first started using electronic records for lab results at York Hospital in 1997 before expanding to nursing and clinical documentation in 2005 and physician practices in 2006.

Yet, the systems didn’t work with each other, spokesman Dan Carrigan said.

As WellSpan acquired other hospitals, the need to start consolidating records across facilities came up more and more. So in 2015, WellSpan signed a contract with software provider Epic to consolidate all of its records into one common network.

A study by the Agency for Healthcare Research and Quality showed cardiovascular, pneumonia and surgery patients exposed to fully electronic health records were less likely to experience in-hospital adverse events. Patients who used an electronic health record were associated with 17 percent to 30 percent lower odds of hospital-acquired infections and adverse drug reactions.

That’s not to say there aren’t some concerns.

Medical Simulation Technician Paul Schreck, left, and Director of Medical Education Michael Bohrn observe nursing students, medical students and respiratory therapy students through a window and via monitors as they work together during a medical simulation clinic at WellSpan York Hospital in York, Thursday, May 5, 2016. The clinic promotes building communication skills within the medical field. Dawn J. Sagert  photo

Dr. Hal Baker, senior vice president for clinical improvement and chief information officer, championed the introduction of an electronic medical record at WellSpan Health. He said physicians now receive training on integrating electronic health records into their care. Instead of bank teller-like setups shrouded in secrecy, physicians are encouraged to set up their monitors to be patient facing. Additionally, doctors are able to use voice recognition software to dictate their summaries, reading them back to patients to ensure they’re correct.

When done properly, patients should feel like they’re included in the conversation, he said.

So far, the benefits seem to be worth the change. WellSpan Health hopes to have its new, integrated system — an effort it refers to as ProjectOne — in place across all locations in Lancaster, Lebanon, York and Adams counties by fall 2017.