PMSI/Practice Partner to expand baseby George SpainIS Technical Publisher PMSI/Practice Partner, a major initiative in outpatient clinics that aims to achieve an all Electronic Medical Record, will expand from its current base of 120 attending physicians to more than 330 by the end of 2005. Practice Partner is a system that keeps track of patient information in an electronic form and can share this information among those who need to know it. When you visit physicians at MUSC clinics, they take your vital signs, ask questions about your medications, ask about family history; then the physician writes or dictates notes on your condition and may prescribe additional medicine, surgery, follow-up visits, etc. If a patient sees more than one clinician, the same data is requested and gathered and filed in other folders. Practice Partner will electronically store this info and make it available to other disciplines, reducing the need for physical storage space. A lot of paperwork and staff are dedicated to keeping track of these notes, so the Hospital and College of Medicine began looking for an electronic medical record that would be available from almost any computer workstation or handheld device. The hospital funded the first decade of the groundwork, but it is the College of Medicine that currently bears most of the cost of transcription, physical storage, and retrieval. Recently the College of Medicine approved 2.25 million to expand Practice Partner to all clinical departments. The hospital picked up the tab of three million dollars during the past several years, but didn’t have the money to expand the service. “I’ve been impressed with the enthusiasm our medical staff has shown during the PMSI roll out. They quickly realize the power of the electronic medical record in collating all aspects of a patient’s care with a simple point and click,” said David Soper, M.D., vice chairman, OB/GYN and president of the medical staff. Soper is also chairman of the physician information council. Currently, Family Medicine, Endocrinology, Internal Medicine, Neurosurgery, OB/GYN, Plastic Surgery and most of Pediatric specialties are using Practice Partner. “We are rolling Practice Partner out in waves. We’re now working on implementing Practice Partner in Neurology, Orthopaedics, Pulmonary, Rheumatology, and Pediatric Surgery,” said Jim Smith, project leader and Ambulatory Care manager for OCIO’s Clinical Systems. The committee overseeing the project includes Soper, and Kim Davis, M.D., Internal Medicine, who chairs the PMSI implementation over-sight committee, and other physicians. “The objectives for Practice Partner are patient safety (fewer mistakes in reams of paperwork), better quality of documentation (regulatory and legal), and coordination of care. A very large part of the project is enhancement of revenue through workflow efficiency, decreased turn-around time, and reduced cost of medical records storage,” said Smith. Initial resistance Smith said that in clinics that adopted Practice Partner, initial adjustment to workflow changes was the main obstacle. After adjustments to the change, “efficiencies of using an electronic medical record are obvious: the note is always available and legible anywhere you are, prescriptions are legible, and patient education is built in if you want to use it.” Dave Northrup, director of clinical care systems of OCIO, noted that the “first six months were ‘tough’ on attending physicians who were encouraged to enter their notes directly into Practice Partner.” Direct physician entry is encouraged, but the system can accept multiple types of data input. Some physicians dictate to tape or write notes and have medical transcriptionists enter the data into the system. Transcriptionists can type physician-dictated notes directly into Practice Partner using its built-in word processing function, or they can enter the notes into a Microsoft Word program and later import the documents into the system. If the physician enters information directly, templates can be used or new ones developed. Many elements can be brought into the note automatically using tem-plates like past history, particular laboratory results, and medications. Once a physician electronically signs a note, it is sent to the Oacis system where other health care professionals have access to the information. “Many clinics at MUSC meet only a few days a week. However, the clinical staff who are there every day adapted to the workflow easier than the doctors,” Smith said. “As with any new system implementation there is a learning curve,” Smith admitted. “However, the vast majority of physicians and caregivers who use the system for awhile told us they never want to go back to a paper system. “In fact, our biggest challenge right now is rolling it out quick enough
for those areas that want to be in the next ‘wave’.”
Friday, Nov. 26, 2004
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