My View • Electronic evolution’s ready to toss the paper charts

As partners in building a sustainable information technology infrastructure for health organizations serving uninsured or underinsured Oregonians, we read with great interest the Aug. 10 story “Record-sharing stalls.” Although we acknowledge the hurdles detailed in the article (patient privacy, high investment costs and difficulty working across organizations), we know firsthand that the challenges are not insurmountable. Our Community Health Information Network — a not-for-profit organization that supports safety-net clinics that serve noninsured and underinsured patients — has been in the IT health business for more than seven years. The network has developed a robust business management and electronic health record system that enables its partners to experience the value of sharing information at the point of care. The Multnomah County Health Department has been a leader in providing essential health services to low-income families since 1977. October 2005 marked the successful beginning of electronic health records implementation starting at one county health clinic. The network has signed security agreements with the county health department and 19 other West Coast-based community health partners that allow us to share critical clinical information across organizational lines, and facilitate quality and cost-effective patient care with patient permission and complete confidentiality. The benefits of electronic health records are significant. Doctors, nurse practitioners and other clinicians all use the system and have gained efficiencies — there’s no more looking for paper charts or deciphering handwritten notes. Lab orders and patient work flow are more streamlined. Medication orders are safer, as information on which drugs a patient is taking is immediately available to clinicians and pharmacists. Remote access to patient records and medical histories allows clinicians to easily track patients after hours. On-call providers can track lab results in cases of urgent intervention. Patients even receive printed documents from their visits, which include important instructions and prescription information. Electronic after-visit summaries are a useful tool for communicating to specialists and hospitals, available anywhere in the world a patient may travel. And improvements to clinical knowledge, such as online charting tools, are helping clinicians make decisions based on best practices and evidence-based medicine. Our investment in this electronic health record system has been substantial and fruitful. We’re committed to developing a community-based asset that will yield benefits not only for our individual organizations, but for the entire health care system. Eliminating duplicate or unnecessary testing increases overall clinical efficiency and reduces health care’s financial burden for individuals, families and communities without compromising quality. Most important, we’ve built an infrastructure that will allow for improved clinical outcomes for our patients. We want to encourage the inclusion of the network’s database — with more than 400,000 individual Medicaid and uninsured patients — in a pilot with hospitals’ emergency rooms. Utilization of the data will provide the entire health system with critical information that immediately will improve decision making at the point of care and reduce unnecessary duplication of services. We’re excited for the health care system — hospitals, heath plans and community-based clinics — as we work together to create a unified solution. Vanetta Abdellatif is director of Integrated Clinical Services at the Multnomah County Health Department. Abby Sears is chief executive officer of Our Community Health Information Network.

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