Archive for Wednesday, November 4, 2009

VA a leader in electronic records

Physicians assistant Roscoe Shepherd looks over his desktop computer as he fills prescriptions at the Veterans Affairs Clinic at 2200 Harvard Road in this 2009 file photo.

Physicians assistant Roscoe Shepherd looks over his desktop computer as he fills prescriptions at the Veterans Affairs Clinic at 2200 Harvard Road in this 2009 file photo.

November 4, 2009


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Editor’s Note: This is the third in a three-part series on electronic medical records.

The Department of Veterans Affairs is a pioneer when it comes to electronic health records and is serving as an example of what a future national health information network might look like.

The VA began using its own electronic health system in the early 1980s, when the Macintosh computer was introduced.

Since then, its system has evolved to include more safety measures and user-friendly programs.

“It’s a very comprehensive, well-integrated system,” said Dr. Sudhir Hegde, chief of primary care at Colmery-O’Neil VA Medical Center in Topeka.

He sat at his computer last week and demonstrated many of the things the system allowed him to do. When it comes to patients, he can see their medications, insurance, military service information, health conditions, consults, lab work and immunizations. The system also allows him to chart their information.

“It is very interesting and revealing to the patient when you show a graph that shows, ‘OK you’ve gained weight now and see how your cholesterol is affected.’ Instead of telling them verbally, you can show them,” Hegde said. “It makes a big impact and it is very easy.”

It also has a warning system. If a doctor prescribes a medication for someone with bad kidney function, it will put out an alert.

Nationwide connection

But what really stands out is the capability for Hegde to see a veteran’s health record from anywhere in the United States. So if a patient were visiting Topeka from Florida and needed a prescription refilled or an emergency room visit, a record of information is available by computer.

“You can look at their office visits and any medications that are prescribed to them,” Hegde said. “It helps a lot in treating patients.”

The VA’s system allows health care professionals at more than 1,400 facilities — including hospitals, outpatient clinics and veterans centers — to share a patient’s record.

For veterans who receive care outside the VA system, doctors try to collect the information and enter it into their system.

“Hopefully, in the future, we are all integrated and can function much more effectively,” he said. “It would help in patient care — no doubt about it.”

The VA and the Department of Defense are setting the pace for the nation when it comes to exchanging electronic health records. They began exchanging information such as lab results, pharmacy data, consult reports and lab work in 2001. In 2004, the system was updated so that each department would receive an alert if a drug were prescribed that might have an adverse effect.

In January, the two systems and a private managed-care company, Kaiser Permanente in San Diego, plan to test a pilot project on how to share information on patients seen by the three systems.

Gail Graham, deputy chief officer of Health Information Management, said the project serves as a model for what the Obama administration hopes to achieve nationwide.

“We certainly hope that this really is kind of a nudge or impetus for accelerated private sector adoption of electronic health record,” she said.

Patient access

The VA also offers its 7 million patients, including 36,000 in the Eastern Kansas Health Care System, access to health information for free on its Web site called My HealtheVet. On the site, they can order medication refills and see parts of their records.

“We are moving to patient-centered care models,” Graham said. “It is essential that the patient and their families be empowered with information and access to the providers.”

The VA recently began testing a program that will send patients reminders, such as that they need to get a flu shot. During the next year, it will allow patients to communicate with health care providers electronically, view appointments and see lab results.

Lori Burton, clinical application coordinator for Colmery-O’Neil, has worked for the VA for 29 years and helped staff move from paper to electronics.

“It was an evolution,” she said. “It took a long time to get each step.”

Besides better health care and fewer medical errors, Burton said Hurricane Katrina showed another benefit of having electronic records.

“If you were a cancer patient and you had been receiving treatment for the last three months, every bit of the documentation for your chemo was gone. There was no one that knew what you had been given,” she said of the paper health records.

For veterans, the information was available electronically.

“For me, it was really eye-opening to see what we have really done here for our veterans,” she said.


Ron Holzwarth 8 years, 6 months ago

I am a VA patient, and the system is amazing. My doc has about 2,000 patients, and when I go to see her, she reviews my chart for ten to fifteen seconds, and sees all she needs to know. After our session is complete, she types in my scripts and whatever else she or another doc might need to know, that takes about 20 seconds. That is then available for any other doctor in the VA health care system to see, anywhere in the country.

If she wants to look back at my chart a few years, that takes only a few keystrokes and less than 5 seconds of waiting.

With paper records, that might take hours or weeks, and to top it off, would only cover care at that one facility.

I had a rather serious hand injury, in including X rays, while out of town in Wichita. Later, my folow up care was done in Topeka, and the records, X rays and all, were right there, within split seconds.

I have an EKG on file. It's normal, and can be retrieved within seconds by any physician within the system for baseline purposes.

They regularly take blood and do tests in a very factory like fashion, and enter it all into the system for any of the docs or PAs to take a look at, should that ever be necessary.

In a similar fashion, prescriptions are filled almost like magic in about 20 minutes. Or, they can be mailed to you. You use your telephone or computer to request a refill, and it shows up in the mail a few days later.

But, in my experience, every once in a while, there are computer problems, and it takes a whole ten minutes to get your records retrieved.

It is amazing, and is obviously the future of health care.

A friend of mine has a job retrieving and replacing paper medical files at a non VA medical facility here in town. The electronic system will one day replace her job.

The programming that made this all possible was developed and paid for by the VA. It will be available free of charge to the remainder of the health care system when the remainder of the health care community has the hardware to operate it.

Your tax dollars at work!

Karrey Britt 8 years, 6 months ago

Ron and vet. Thank you for your comments. It's nice to hear from those who experience the system firsthand.

erobinson89 8 years, 6 months ago

I am a 76 yr old Disabeled Vet and have been using two Chicago VA Hospitals. From 2000 thru 2008 I used the Northside VA Hospital (Jesse Brown VA Hospital) seeing Multiple doctors and Clinics and having X Rays, MRIS CT Scans & multiple surgeries.. After moving from Chicago to Niles Illinois I decided to begin using the James Lovell VA/Naval Hospital in North Chicago. What I found out this year was that this so called excellent record system using computers was very flawed and useless, as the VA doctors at the Lovell VA Hospital could not pull up and view the records previously placed within the computer by doctors at the other Chicago VA Hospital; Also tests, X Rays, MRI Scans and Cat scan data was unavailable to them as well. This system needs a lot more work on it to make it a viable system and useful for all Veterans and Doctors.This system is not what it purports to be.

Ron Holzwarth 8 years, 6 months ago

I don't know about EVERYONE's experiences, all I can talk about is my own.

My medical records from the Topeka VA were pulled up in a few seconds at the Wichita, Kansas and at the Loma Linda, California VA hospitals without any problem.

jumpin_catfish 8 years, 6 months ago

Many thanks to all our vets for their service and sacrifice.

justmememe 8 years, 6 months ago

Too bad it can't help my father, a Vietnam vet, whose records are suddenly lost in a warehouse somewhere now that he's trying to have his disability benefits reevaluated. He was advised to drop it or lose the meager benefits he has now.

TopJayhawk 8 years, 6 months ago

Great, now the VA can get electronic help to kill it's pt's.

Jean1183 8 years, 6 months ago

My son who is a vet, needed to know when his last tetanus shot was. He was able to look it up on-line.

When I worked at Lansing State Penitentiary several years ago, they also had a pretty neat electronic medical record system.

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