Technology... Who Knew?
By Carol King, Corporate Director IS, EMHS
When I was a girl growing up in a small northern town in Maine during the 1960s I’m pretty sure my three sisters, two brothers, and I never dreamed about computers and the role technology would play in our lives. We didn’t even have a remote for our television which only had three channels! I grew up in a middle class family in a town of about 550 people. My dad was a mechanic and my mom stayed at home and occasionally worked for a potato farmer. I spent my childhood surrounded by family exploring, playing, and enjoying a pretty simply tech-free life.
I had no idea that when I got a part time job at EMMC during college it would change the direction of my career. When I started in registration in 1979 no one had ever heard of an electronic medical record. Patient information was kept on index cards and any update to their information was made using a typewriter. I truly enjoyed my job and attended school around work schedule. I earned a bachelor’s degree in business from the University of Maine and then my Masters of Science degree in business from Husson University.
By then, the inpatient registration process was a combination of manual and automated tasks. I could see the potential and the advantages of using technology to reduce errors. So I decided instead of writing a thesis for my Masters, I would do a project that would analyze the history of each provider’s admissions and the length of stay associated with those admissions. We would use this data to educate providers on a new way of billing for their services called DRG (diagnostic related groups). Healthcare was changing and we needed to make sure we were properly paid by Medicare and following their new guidelines of paying for a pre-determined length of stay based on diagnosis verses the fee for service model that was used for years. This change would turn a simple billing system into a complex integrated system that would affect all aspects of healthcare delivery.
Slowly but surely healthcare became automated. First came automated billing. EMMC physicians were offered the option to install a computerized patient receivable software system. Insurance forms were completed on a printer instead of a typed form. Simple as it seems, this was a huge step forward. EMMC was even then a leader as they created a connection for providers to retrieve patient information when needed t. Think about that, the ability to get what you need when you need it! We helped providers understand the paper process, to examine what worked and what didn’t and then re-engineer the billing process to find efficiencies and reduce the amount of time it took to receive payments from patients and insurance companies.
In the mid 90s the reputation our department built for service had providers approaching us to look for an electronic medical record (EMR) to install, implement, and support. We approached this from the workflow redesign position and spent many hours watching and learning how providers worked. We had to educate patients regarding the change so they understood that the chart a provider carried was now going to be a screen that they read, the pencil was a key pad. We had to show them that we could keep the patients them healthier when we could see what was happening to them over time and when we could intervene early. We interfaced things like lab and radiology reports from the hospital systems into the practice EMR. As soon as a result was available at the lab it’s sent directly to the provider. No more paper, no more delays, no lost results.
We now offer patient portals along with secure e-mail so, patients don’t need to pick up the phone; they can request an appointment or lab test via the patient portal, see the response, and the result anytime and anyplace they can connect to e-mail. Patients can even have an e-visit with their provider without leaving work. Insurance companies are on board with this practice and reimbursing practices for the service. This is a win/win for everybody.
Over the years we’ve created a disease registry that allows practices and providers the ability to analyze clinical data and assure we look at the patient information from many levels. A provider can see when a patient needs to be seen, the practice can use the information to show payers data required for performance indicators which increase their reimbursement. This type of proactive intervention makes our healthcare system a leader in the field. Honors such as the Davies Award and the Beacon grant recognize the work and facilitate further funding to assist in the development of using data to help our patients.
Today I’m part of the planning and implementation team for the Bangor Beacon Community. I’m part of a team who is working to devise a way to develop the infrastructure to capture the movement of data within this community and facilitate standards that will be used in the future roll out of these tools to the greater Bangor area and the state.
When I look back I think we’ve come a long way. If you put it all together it’s been an amazing ride. My focus continues to be making sure that the information that is necessary for patients to be treated anywhere they choose is accessible, affordable, and easy to access for everyone. I like to think of it using the definition of healthcare delivery we often hear from Dr. Erik Steele, “it’s all about your Momma,” we treat every patient the way we want our mother treated. It is my honor to play a role, however small in a system that thinks like this….