In the uphill climb to convert paper health records into electronic form, the need for longevity is becoming as pressing as the need for manageable, integrated systems, said Dr. John Edmonds, clinical director of medical informatics at the Hospital for Sick Children. Converting patient charts to electronic media can also require the fast digitization and integration of paper notes from the present. The Synergize product will allow Sick Kids to quickly store, share and access electronic patient charts, offering a way to get started on an electronic health record (EHR).
“”The long term, strategic plan for both Sick Kids — and I think any health care institution — is to have an entirely electronic record,”” said Edmonds. “”It’s difficult to get the information in at the time you are collecting it, so a lot of notes are still on paper.””
While many hospitals have the ability to scan paper documents, the process is time-consuming, and newly scanned material must be further synchronized with the existing digital data. Edmonds said that the Synergize system meshed the two phases nicely.
“”We can call up any documents that were in a paper copy and be able to view them using Electronic Patient Charts, and it’s nicely indexed. It’s an electronic version of the traditional health records paper chart,”” said Edmonds.
Colin Ruskin, vice-president of business development for Microdea Inc., said Synergize was a good fit for Sick Kids’ electronic records needs because of its focused approach.
“”Typically hospitals purchase these ginormous, monolithic management systems that try to do everything. They’re an inordinately large amount of dollars and a huge amount of work to try to get them into place,”” he said. “”Synergize was built to manage charts, so you just get a product that manages charts and does charts very well.””
That said, the cost of technology dictates that a fully electronic charting system, such as one that would include practical handheld input devices, remains a long way off for hospitals like Sick Kids. Right now, new chart information is updated via stationary terminals, such as those in doctors’ offices or at nurse’s stations.
Synergize will allow the hospital varying forms of chart security, including the ability to audit users to ensure they are looking only at the records they should be. Ultimately, the electronic charting system will be far more secure than the generally unquestioned methods of the past and present, Edmonds.
“” People who were using paper systems never really thought about why they shouldn’t be looking at a paper chart of a patient they didn’t have anything to do with,”” said Edmonds. “”We have taken the approach that we will not block access to any records . . . in a hospital environment, that would not provide good access to patient care.””
Ruskin sees tremendous potential in the future of electronic patient charts, especially in an emergency environment.
“”Suddenly you end up with 600 pages arriving at your desk when you were really only looking for a couple of pages or a last progress note,”” said Ruskin. “”Without electronic charts there you’re again pulling charts and it’s difficult to provide quick turnaround…and in that environment I think quick turnaround is critical.””
And while electronic health records may still sound like a thing of the future, those who call upon them decades from now will need to rely on what will then be technology of the past. Nowhere is this more of a concern than in organizations like Sick Kids, where law requires patient records to be kept on file for 28 years.
“”How do you maintain access to electronic data for that length of time? Most commercial vendor hospital information systems are very vendor-specific for the software you need to view that data.”” Edmonds said. “”You still need that application to get the information out of that chart.””
Synergize stores its data as TIFFs rather than in a proprietary format. The hospital plans to phase out the filing and indexing of paper records as the new electronic system proves robust, eventually destroying the paper copies.
“”We’re comfortable that the security of the data on that system is as good as microfilm or paper,”” said Edmonds.
While access to affordable technology remains a key issue, Edmonds pointed out that such a monumental overhaul in hospital procedure inevitably takes time due to the fact of doctors and nurses being ever on the go.
“”I think we’re going to be five or 10 years away from a completely paperless chart,”” said Edmonds.