Lower the learning curve with Web technology
MCO goes on-line with electronic medical records
Effective cross-continuum management of chronically ill patients depends on the ability of clinicians to share information quickly, experts agree. Consequently, about 30% of health care organizations have established electronic medical records of some type, says David Hutchinson, RN, an acute care nurse in pediatrics at the University of California Davis Medical Center in Sacramento. And almost all of the remaining 70% are either in the process of implementing an electronic record system or are at least seriously considering it.
What they may not have considered, however, is the expense involved with purchasing a license to use proprietary software packages, and sometimes even hardware, from large computer companies. A different and less costly solution, Hutchinson says, is to use already established Web browser technology as an interface for medical record systems.
Clinicians at the University of Pennsylvania Health System (UPHS) in Philadelphia are using Internet Web browsers to pull together information from multiple financial databases even some databases written in different types of computer code, says Richard Cramer, manager for clinical systems at UPHS. "We have a data warehouse that has data about our full-risk patients and our inpatient and outpatient/ambulatory environments," Cramer says. "That’s claims and billing data. We’re also in the process of building standardized reports that will be accessible through the Web from that data."
When Cramer says "Web," however, he doesn’t mean the Internet. Rather, these databases, and the browsers used to access them, support the health system’s intranet a closed electronic network designed to be used only by a specific group of people.
In addition to being cheaper than a commercial information system, the University of Pennsylvania’s browser approach has shortened the learning time of staff dramatically, Cramer says. Because users are already familiar with the Web browser software, it’s not necessary for them to learn the details of an elaborate system in order to get the information they need.
Cramer adds that the intranet system has been particularly useful for UPHS’ 10 disease management programs, which until recently, had been paper-based. "We used to have a notebook, which we would take out to the [program] sites where they’re participating in our pilots for each disease," Cramer says. "We would give the administrators 15 or 20 pages of paper that encompass decision trees, reference materials, summary sheets, and data forms. Now, we have migrated all of those forms and all of that paper to our intranet."
Cramer adds that UPHS has a disease management home page on its intranet, from which the system’s clinicians can reach any of the 10 programs. Administrators at the programs also can use the home page to access updated disease management protocols. "So each time we change or update something, we can just tell [the programs] via e-mail that, for example, the congestive heart failure program has been updated, so please go print out page number three. So we’ve really eliminated a lot of paper as far as updating and distributing information to the programs."
That’s important, considering UPHS has 26 different sites participating in its disease management programs, all spread out across a 50-mile radius around Philadelphia. "Given the rapid pace at which we’re developing this stuff in house to keep up with clinical advances, it would be prohibitive to have to go out and update a client application at each one of those sites. With the Web browser technology, we just update it on our server, everybody has it, and it works great."
[For more information about the University of Pennsylvania Health System’s intranet for disease managers, contact: Richard Cramer, manager for clinical systems, University of Pennsylvania Medical Center, 3440 Market St., Suite 600, Philadelphia, PA 19104. Telephone: (215) 662-7645.]
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content