A Healthier Future Through Technology

UT Health Institutions Use Electronic Medical Records to Improve Patient Care and Safety

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Q&A with Dr. Kenneth I. Shine, Executive Vice Chancellor for Health Affairs.

Why is it important that the UT health institutions invest in health information technology?
There are countless reasons why health information technology is beneficial to patients, doctors, nurses, staff and our institutions. But, I don’t think there’s anything more crucial than improving the quality of medical care and patient safety. I’ve been invested in a movement to reduce medical errors and improve safety for more than 40 years. When I was president of the Institute of Medicine, we released a report called "To Err Is Human: Building a Safer Health System" in 1999 which raised awareness of safety issues on a national level. We found that 98,000 patients were dying every year due to preventable errors. I see health information technology as an incredible tool to help us continue to combat this unfortunate reality. Electronic medical records (EMRs) enable everyone in a patient’s care team to have the same, immediate access to a complete, up-to-date and accurate record of their care. Patients can allow trusted family members to access their records and doctors can more easily collaborate with other doctors responsible for a particular patient’s care. Future complications will be more easily predicted and we can further embrace the concept of preventative care and stop issues before they occur. With so many people who are invested in the patient’s well-being having the same real-time data, the chance for mistakes is drastically reduced. Mistakes due to the poor legibility of handwriting will become a relic of the past and alerts that prompt doctors to a patient’s drug allergies, possible harmful drug interactions and remind them to administer the appropriate test at the right time also help minimize risk. The systems also allow doctors to analyze the outcomes of patients under their care to ensure quality levels are being met. Finally, HIT systems will play a key role in future medical research and will help our institutions collaborate with one another and other health providers to uncover medical breakthroughs.

In addition to the benefits provided to patients, doctors and their staff, are there other advantages?
Errors come with associated costs, so their reduction translates into cost savings. And, the same measures health information technology systems are using to reduce errors — access, alerts and reminders — will also help our institutions cut costs while boosting efficiency and productivity. For example, repeated medical tests by different doctors will be alleviated since the data will be available to all parties who need it, when they need it. It also promotes much more efficient communication not only with doctors and nurses, but with administrative staff. When patients submit questions online, they chose the appropriate category, such as appointments, billing, insurance or prescriptions. The question is then routed to the appropriate staff. In addition to improving customer service by providing faster and better answers, this has also increased productivity as staff don’t have to field questions that fall outside their area of expertise as often. Also, our reliance on paper will be diminished. Our institutions won’t have to dedicate nearly as much space to record-keeping and can use it for other purposes. The cost of electronic storage is much less than for paper records. And, because of the sheer volume of data, productivity will increase as staff will be able to much more easily and quickly locate needed information. Even after a patient’s file was found before, the one piece of needed information may have been checked out. In fact, patient records might have been stored at different locations. Bringing them together for a complete review often required copying, faxing or transporting the documents. These activities are time-consuming, resource-intensive, complicated and expensive. With an EMR system, all needed records can be accessed from anywhere in the world, by all authorized parties.

Do you see any challenges?
With so much information being exchanged electronically, naturally there are concerns about security and privacy. Fortunately, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) established rules to protect the privacy and security of electronic information. All electronic medical record messaging is encrypted from end-to-end, ensuring that sensitive communications are secure. Our experts in the area, such as Kirk Kirksey at UT Southwestern Medical Center - Dallas, assert that EMRs are actually much safer than paper records because of the encryption, monitoring systems and the policies and procedures that are in place. The systems also include various security levels so that only authorized people can see particular patient records. For example, doctors can only see their own patients. Compare this to a paper-based system where folders of sensitive information could potentially be laying out for unrestricted people to see. A larger issue may actually be physician adoption. These systems not only change the way doctors work, but also the work processes and procedures in their offices. It also changes the dynamic in the room with patients. And, many pieces of medical equipment now include an interface that allows doctors to enter notes and findings instead of making a handwritten note in a paper file. That data then feeds into the patient’s electronic medical record. Physicians are obviously very busy people and many have been working with paper-based systems for many years, with a high level of success. Taking the time to learn a new system and make a dramatic change can be difficult. But, the ones who do make the transition are finding it incredibly beneficial and we’re confident that word will spread.

How does the American Recovery and Reinvestment Act of 2009 impact UT institution health information technology efforts?
The act allocates billions of dollars to help physicians and hospitals acquire and implement health information technology across the United States. That gives evidence, in no uncertain terms, that it is at the forefront of the national health care agenda. In fact, the federal government has an ambitious goal of an electronic health record for every person in the United States by 2014. This national support gives our UT institutions even more incentive to continue the expansion of their HIT programs. For example, UT Health Science Center – Houston (UTHealth-Houston) recently secured two federal stimulus grants totaling $30.3 million. One of the grants provided $15.3 million to establish the new Gulf Coast Regional Extension Center. Part of a network of regional extension centers across the country, it will enable UTHealth-Houston to improve the quality of health care in our state by providing community-based primary care physicians and other health care practitioners training, technical assistance, guidance and information on best practices to accelerate the adoption and meaningful use of electronic medical records. The second grant is valued at $15 million and establishes a National Center for Cognitive Informatics and Decision Making in Healthcare. Collaborating with other institutions, the center will work to make health information technology systems easy and inviting to use. In order to achieve widespread adoption, by both patients and health care providers, this is essential. After all, implementation of the systems won’t do any good if they are not used. (Read more about the grants.) This is just the beginning of a sea change and the UT health institutions are leading the way.

Photo of Dr. Kenneth I. Shine

Dr. Kenneth I. Shine, Executive Vice Chancellor for Health Affairs.

More Information

Health Information Technology for the Future of Health and Care
U.S. Department of Health and Human Services website providing information about HIT and programs being implemented to spur its adoption nationwide.

Recovery.gov
U.S. government website dedicated to outlining the use of funds from The American Recovery and Reinvestment Act of 2009. One of the act's long-term investment goals is "…to computerize health records to reduce medical errors and save on health-care costs."