Thursday, January 27, 2011
No one adores repetitive and seemingly endless medical forms. But while most humans grumble and grab a pen, Carmel native Christine Kerner – after filling out what she estimates is hundreds of forms during a three-year battle with her son’s parasitic infection – decided to do something about it.
In 2009, she partnered with local oncologist Kent Bransford, MD, to launch a health care website designed to compile family health histories and remind users about immunizations, tests and procedures they shouldn’t miss based on things like age, sex and race. Two months ago, Juniper Health was born.
“I wanted to create something that would eliminate the need to spend 30 minutes filling out paperwork each time you go to the doctor,” says Kerner. “With this system, you don’t have to have a file at home filled with paperwork and immunization cards – you can just pull it up on the Internet.”
Juniper Health users can keep their health records up to date electronically at no charge, download and e-mail them to their doctor prior to their appointments. While the online form cannot be used as a substitute for hospital forms yet, it can serve as a supplement.
Aside from being an efficient tracking system, Bransford believes Juniper Health’s primary benefit is its role in preventative care.
“I see patients in the final stages of fatal diseases, which in retrospect, could have been preventable had they been caught early,” he says. “We now can help people get the right treatments based on their health history, so we can spot these things early.”
With automatic monthly e-mail reminders, Juniper Health informs users if they have “to do” items, such as vaccinations, mammograms, or cancer screenings, as recommended by the Centers for Disease Control and Prevention. At a later date, Bransford hopes that list will include medication reminders.
“It’s all about putting you on a more level-playing field with your doctor, so that you can advocate for better health care,” Bransford says.
Nationally, the switch over to electronic medical records has been a slow process, although with President Obama’s 2009 Health Information Technology incentive requiring hospitals to convert their records in the next five years, more providers are coming around.
Dr. Joanna Oppenheim, MD, a family practice physician in Salinas, has been working with electronic medical records for 10 years and can’t imagine going back to paper charts and refill slips.
“It used to take a day or two for the doctor to even see a refill request; now it’s something you can do with one click,” Oppenheim says. “The speed of response for patient inquiries is greatly increased.”
Electronic medical records also allow Oppenheim to have access to her patients’ information from home, keep track of necessary screenings, and have better communication with patients.
But if EMR systems are so great, why aren’t more medical offices jumping at the opportunity to incorporate them?
According to Jenny Field, director of Ambulatory Medical Informatics for Salinas Valley Memorial Hospital, the benefits can be difficult to see during the implementation process, which can be long and expensive. However, with the government stimulus motivating physicians, it’s “not a matter of if, but when.”
Prior to implementing an EMR system at the physician offices Field oversees, her team did an extensive search for the best system, performed site visits and initiated a pilot implementation at a test facility nearly three years ago.
Today, 70 physicians and 300 clinical staff are currently using the EMR system. “It’s working really well,” Field says.
“It completely changes the process,” she adds. “The system notifies the physician if there is drug to allergy interaction; lost charts are no longer a problem; duplicate health tests are eliminated; test results come back immediately; and with audit trails, you can see the name of every person who has ever looked at your record and when.”
Though the Monterey County Health Department has had 250 county staff using their Netsmart Avatar EMR system since July 2009 – an additional 250 contractors will be trained by July 2011 – eliminating the initial “I don’t type” response to digital records and addressing the learning curve, was challenging, but worth the effort.
“Electronic records have increased the ability to communicate between providers,” says Dr. Wayne Clark, director of Behavioral Health for the department. “Now the ER can pull up medical information from the physicians community and vice versa in order to make accurate, data-driven decisions in real-time.”
EMR skeptics often question if personal data is secure on the Internet – and with well over 100 EMR systems to choose from, it’s not hard to see why – but every system has its own method of protection. At Memorial, the records are kept on a server at the hospital so that a physician’s lost laptop does not mean lost records, and Juniper Health is set up like a HIPAA compliant banking system to ensure security.
Still, the concept of having a computer present and playing a vital role in the doctors office remains controversial.
“Physicians struggle with how to connect with a patient in the room while the computer is on,” says Oppenheim, who occasionally receives complaints of doctors constantly typing during appointments. “There’s an issue of instantly documenting the information, but once the patients and doctors get used to the computer interaction, it won’t be such a problem.”
EMR systems are far from perfect – after all, nearly every hospital and physician’s office uses a different one – but unless medical offices don’t mind incurring fees from the government, patients will come to know them very well in the next three years.
And that’s more than all right with Oppenheim, who claims her favorite aspect of the EMR system is you can actually read it.
“It’s legible!” she says. “Doctors have the worst handwriting in the world!”
To learn more about Juniper Health – and to sign up for a free account – visit them at www.juniperhealth.com.