Douglas County among few health departments to digitize patient records

1 | HIE-HIT, Public Health

Jennie Henault, (left) Director of Administrative Services at the Lawrence-Douglas County Health Department works with office assistant Debbie Mitchell to prepare to switch from paper to electronic health records.

Jennie Henault, (left) Director of Administrative Services at the Lawrence-Douglas County Health Department works with office assistant Debbie Mitchell to prepare to switch from paper to electronic health records.

— The Lawrence-Douglas County Health Department will be closed for two days next week in order to finish implementation of an electronic health record system.

The clinic and staff offices will be closed from 8:30 a.m. to 1 p.m. on Dec. 4 and 5, as well as Dec. 26 while it trains staff on the new system.

Douglas County is now the fifth in the state to have its health department transition from paper health records to an electronic system. The others are Johnson, Wyandotte, Shawnee and Lyon counties, according to the Kansas Association of Local Health Departments.

Since 2009, use of electronic health records (EHRs) has been surging among hospitals and doctors, thanks to federal incentives to make the costly transition.

But of Kansas' 100 health departments, only Shawnee and Lyon qualified for the incentives because they are also Federally Qualified Health Centers.

In Lawrence, it made sense to implement an EHR even without the incentives, said Jennie Henault, director of Administrative Services. She said the new EHR system also will include new staff scheduling and reporting systems, both of which will greatly improve efficiency.

She said scheduling had been done in Excel, software made for spreadsheets. Consequently it was cumbersome to schedule a single appointment that spanned two program areas, such as immunizations and family planning. It also was not uncommon for staff members to double book or delete appointments scheduled by others.

"It was just very very easy to make mistakes or overwrite each other," Henault said.

Likewise, she said the reporting system will save staff members countless hours of manually compiling reports due to limitations of the current system.

"That was one of the biggest things we thought about, even after we found out we wouldn't be eligible for the incentives," Henault said. "Especially for time-sensitive information. For some grant funding and some mandated reporting, you have to be able to get that information quickly. And our health board wants more information, our director wants more information. It just doesn't make sense to keep wasting time manually counting things and going through pages and pages of reports."

An added benefit, she said, would be the capability of connecting to the statewide Kansas Health Information Exchange, which began exchanging patient data this summer. The exchange allows connected health care providers to use a private, secure network connection to quickly transfer digital health records instead of relying on fax machines or patients to deliver paper records.

When the health department would connect to the exchange, Henault couldn't predict — but when it does it will primarily be useful for immunization records and family planning records, such as Pap test results or medications lists, she said.

Cost-benefit analysis

It makes sense for the state's largest health departments to implement EHR systems, said Michelle Ponce, executive director of the Kansas Association of Local Health Departments. But it doesn't for most smaller health departments because of their lower client volume and limited budgets.

"At least in the current environment, I don't think it's something they must have," Ponce said. "It's almost a management decision for many health departments because they're different than a primary care provider. What it comes down to is what benefit will they receive (from an EHR) and does it justify the cost."

In Coffey County, health department administrator Lindsay Payer said she budgeted to implement an EHR system in 2013, but now is not sure she's going to do so.

"At this point it heavily relies on the needs of the health department and is that money more useful somewhere else at this time. It will just depend on our financial status," Payer said.

The health department association is currently developing a tool to help local departments make the cost-benefit analysis of implementing an EHR. Ponce said it should be available in January.

Coverage of electronic health records in Kansas

Overview
Kansas breaks ground on statewide digital health network (5/28/12)
The pros and cons of health information exchange: An interview with Dr. Joe Davison (5/28/12)

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