EMR

The Power of the Electronic Medical Record

Q&A with UConn Health’s first chief medical information officer (CMIO), Dr. Dirk Stanley

Q

How transformative is an EMR tool for hospitals and physician practices?

It’s not just the electronic medical record that is so powerful — it’s the medical record in general. In his 1968 New England Journal of Medicine article, “Medical Records that Guide and Teach,” Dr. Larry Weed posited that the way we store information changes the way we think about information, which in turn changes the way we act on information. So a properly designed medical record can lead to improvements in communication and care. Medical records have since gone electronic, opening up even more opportunities to streamline communication and patient care. To do this effectively, however, requires technical people who understand the needs of the patient, the physician, the entire care team, and the health care organization. That’s where it’s helpful to have a clinical informaticist guiding an organization through the process.


Q

How impactful is a single, comprehensive EMR system for improving patient care?

Overall, an EMR is a win for the patients and a win for health care. Putting all inpatient and outpatient health care providers, physicians, nurses, pharmacists, and other clinical staff on one EMR platform is both a great opportunity and a daunting challenge. It allows for a degree of communication that was never before possible, with the entire care team having immediate access to the same patient data. But it can also present unexpected operational challenges, such as determining who is responsible for which part of the patient’s clinical care. EMRs save time spent tracking down paper charts, are much more secure and legible, and can be easily shared with patients and their caregivers. They also provide researchers access to large volumes of clinical data, which can lead to further care improvements, new therapies, and patient-care standards.


Q

How can an EMR help practices become more clinically and financially efficient in their delivery of high-quality care?

One of the most powerful tools within an EMR system is clinical decision support (CDS). Those little electronic alerts and other design features help guide the physician to the latest guidelines, most recent evidence, and most effective care, since it can be hard to keep up with the heavy volume of new medical information that they need to know. CDS can be used in a wide range of areas, including patient care, patient safety, coordination of care, and for cost reductions. In an outcomes-driven environment, providing great patient care can help translate into improved financial health for an organization.


Q

What is on the horizon when it comes to EMR at UConn Health?

We are currently meeting with people across the organization to help us configure our new EMR system, called HealthONE (Epic). Creating the platform will also allow us to build other evidence-based tools to further improve care and research opportunities here at UConn Health, in the Hartford region, and beyond. We are planning to launch this to our patients and providers in April 2018.

How Should Medical Providers Prepare for Value-Based Care?

Q&A with Dr. Andrew Agwunobi, chief executive officer & executive vice president for health affairs at UConn Health

UConn Health University Tower

Q

What exactly is value-based care?

Value-based care means that future health care payments to medical providers by patients, insurance companies, and governmental agencies will most likely be formulated using a combination of key high-quality care metrics of each hospital’s or doctor’s office’s performance, along with an average of state or national health care service costs.

Medicare has indicated that by 2018 it will move to a value-based payment model. It is anticipated that commercial payers such as insurance companies will follow suit. Failure to provide value-based care in the future will potentially result in decreased payer reimbursements, financial penalties by the Centers for Medicare & Medicaid Services (CMS), and a shrinking number of patients using a medical provider’s services.


Q

How can medical providers best adapt to this new growing trend?

All medical providers, small and large, need to ensure delivery of health care is as cost-effective as possible, and is truly improving patients’ experiences and outcomes. Providers need to implement quality improvement initiatives, track them closely, and make sure key clinical quality metrics are measured and met. But they must also focus on improving the “value” of care, contemporarily defined as health outcomes achieved per dollar spent.

To meet these new expectations and to remain competitive, many health care providers across the nation have been joining or creating accountable care organizations (ACOs). An ACO is a voluntary collaboration of doctors, hospitals, and other health care providers who coordinate care and adhere to quality and efficiency standards in order to provide the best patient care at the most affordable cost possible.


Q

How is UConn Health preparing for value-based care?

UConn Health recently completed a successful large-scale, aggressive cost and savings initiative that is yielding ongoing annual operating and financial efficiencies. Now to remain even more competitive and provide great care at the best cost, we are currently looking at creative affiliation opportunities. We are exploring joining one or more existing ACOs in Connecticut at a leadership level. Our goal is to increase patient access to health care, while improving quality of care and our patient outcomes, and reducing the costs of achieving such good outcomes for our patients.

As part of our efforts toward value-based care, this spring we will begin the implementation process for a new, integrated electronic medical record (EMR) system called Epic. This is a nationally recognized clinical documentation system with the functionality and the capability to integrate all of UConn Health’s patient information across clinical care locations, physician offices, and medical providers into one accessible database.

This EMR will allow the sharing and receiving of the latest medical history of patients being cared for both at UConn Health and at other institutions, while providing our clinicians, researchers, and educators with a state-of-the-art clinical platform to support their ongoing missions. This EMR endeavor will enhance high-quality and cost-effective health care delivery for our patients and people of our region, and will allow for increased population health management.