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Fort HealthCare Compass electronic record improves quality of care

Health, Wellness & You
Tuesday, November 1, 2011
Doctor Edwin Fischer has been practicing medicine in Jefferson County for more than 30 years. A graduate of the University of Wisconsin Medical School, he trained in an environment that featured the newest and brightest technological breakthroughs. As a family medicine physician based in Lake Mills and as medical director for Fort HealthCare’s Fort Medical Group, he keeps a constant eye on the many ways technology can improve the quality of care delivered to his patients and those of other physicians. As medical director, he knows that Fort HealthCare must adopt those tools and practices that ensure the best quality care is delivered today and well into the future.
Fort HealthCare’s ongoing effort to provide the highest quality care is greatly enhanced by the implementation of a system-wide electronic health record (EHR). In partnership with the Cerner Corporation, more than 50 Cerner Solutions – a solution being a radiology information system, a pharmacy system, a laboratory system, a nurse documentation system- have been installed to provide physicians and other care givers access to the highest level of medical record technology. The partnership’s main goal is to upgrade existing health record capabilities at Fort HealthCare and to create a medical record system that provides critical medical data whenever and wherever needed. The Cerner EHR software system, known internally to Fort HealthCare staff as the Compass project, became available throughout all hospital and clinic locations on August 1.
The Compass project relies on these Cerner Solutions to create a comprehensive electronic health record that can be viewed by any doctor, nurse, pharmacist and therapist across all clinical programs at Fort Memorial Hospital and all primary and specialty clinics operated by
Fort HealthCare’s Fort Medical Group. Fort Medical Group records can also be viewed by physicians at area UW Health and Dean/St. Mary’s Regional Clinic locations.
The integrated medical records software now allows all to access one patient record at the same time—an impossible task with a cumbersome paper chart. This access to relevant, integrated clinical information enables medical professionals such as physicians, nurses, pharmacists, therapists and lab technicians to communicate instantly with the rest of the patient’s care team and enables them to make the best care decisions possible. 
The promise of the Compass Project EHR goes well beyond efficiency in locating critical patient-related medical information with a few clicks of a computer mouse. The greatest benefit and the driving force behind the EHR’s implementation was the impact the new software will have on improving the quality of patient care- whether this occurs in a doctor’s office, in the emergency department, in one of six operating rooms or bedside on one of the four nursing units at Fort Memorial Hospital.
Fischer is pleased with how the electronic record enables doctors, regardless of their location, to coordinate medical care. “There will be one chart for each patient viewable at any of our Fort Medical Group clinics and in the hospital.  If I see a patient in my office and send them over to one of our surgeons for consultation, that surgeon will be able to open the same chart and look at the note I wrote, and if they need to go to the hospital or shows up at the emergency room, that doctor will be able to look at the same chart- all my notes, right there.”
Mobility features are another benefit for patients and physicians, especially in emergency situations. Physicians are able to receive critical data elements or requests anywhere. When on call, or covering for another physician, or simply away from the office and a patient is need of advice or treatment, the medical information is available on any smart phone. Fischer notes that he can offer patients better advice such as directing them to go to the emergency room when a concern is serious, or take two aspirin and call him in the morning when more urgent treatment is not indicated.
He is similarly impressed with the impact electronic records will have on the way medicine is practiced well into the future. Fischer added, “This is a paradigm shift in how we practice medicine. The end result is the same kind of decisions: who is sick, where do they need to be treated and what kind of treatment should be prescribed. But hopefully, this will greatly improve the safety of our care, the consistency of our care and the thoroughness and quality of our care.”
Fischer offers an example. “The Compass EHR provides for a template form of recording. Specifically, that means that instead of me writing down that a heart exam was normal, there is a template and it will say “heart” and many different options about what I heard or saw or felt. There are specific boxes that I can check to indicate what I’m seeing, and that creates discreet data points rather than a flowing narrative. Those discreet data points- allergies, diagnoses, medications, x-rays, lab results- are then all easily catalogued and then can be quickly recalled.” 
The benefits to patients are many. For example, if there is a medication recall, pharmacy staff can put immediately determine all patients who are on that medication. “And”, said Fischer, “we can easily remind patients to get their colonoscopy screening done or that it has been three months since their last diabetes test. In the past, where we’ve relied on tickler systems or our brains to remember things, now, the computer can keep track of that.” He dismisses the notion of some that technology will replace the “art of medicine”. Instead, an EHR like the Compass project at Fort HealthCare helps to increase the science of medicine and improve the technology that keeps clinicians from missing or forgetting elements of care.
The benefit of greater consistency of care is that it helps all involved provide better medical care resulting in better outcomes for patients. Fischer is optimistic about how the EHR will enhance the relationship between patients and physicians. “Hopefully, through our improved monitoring of quality indicators and improved interactions with our patients, we can decrease critical medical events or hospitalizations and avoid those situations that become emergencies. We can also decrease emergency room visits and provide higher quality of care at lower cost by doing a lot more preventive care on the front end.”
Within the many Cerner solutions being installed at Fort HealthCare, there are countless tools to improve overall wellness, including one product called Lighthouse, which gathers discreet data points. It can pick up trends in patients’ health as they are proceeding through a hospitalization or while being seen regularly for chronic disease care in the office. For example, the sepsis module will look at different data points or vital signs trends and will predict that a patient is becoming septic- a system-wide infection in their body- and notify the doctor before the doctor might have actually seen it coming. Similar modules monitor diabetes and congestive heart failure, among others.
“One of the big reasons we chose Cerner is because of their vision,” said Fischer. “We were able to see the road map as to where they are taking the field of electronic medical records. I think they have a wonderful vision and are very much interested in not just taking care of illness but in promoting health.”
Mike Wallace, president and CEO at Fort HealthCare is similarly excited about the promise of the Compass project. “The Compass EHR will allow us to provide the highest quality, safest medical care possible and help our patients manage their own healthcare. Compass will support clinicians’ ability to make the right decisions and provide the right care at the right time and provide aggregate and individual data to monitor and reward positive health behavior. This will ultimately help us improve the long-term physical welfare of the community- resulting in improved long-term economic benefit for all.”