Sitting in the basement of University Health Services are about 100,000 paper records of patients’ visits, lab tests and medical histories. But this number won’t be growing anytime soon, as UHS is in the process of going paperless.

UHS recently began phasing in an electronic health record keeping system, to record patient information. The new system, which will be fully implemented next summer, is part of an effort to remedy current communication problems with the University Hospital.

With the former paper system, if a patient was tested at UHS and then referred to the University Hospital, the patient was required to repeat certain tests such as blood samples or X-rays. The transition to the new digital system — expected to be completed in August 2012 — will make all UHS test results and other clinical information available electronically to authorized University of Michigan Healthy System staff.

Currently, UHS operates mostly with paper records, while the hospital uses electronic records. Robert Winfield, the University’s chief health officer and director of UHS, said the disaccord between the systems has caused communication problems.

“For as long as I’ve been here, we have struggled with a way to share lab reports, visit reports or extra reports without just copying them and putting them into the patient’s hand and saying, ‘Please take these with you,’” Winfield said.

Though the use of faxes to exchange reports has helped, documents sent by faxes are often received by the clinic and never actually make it into the hands of a doctor. Additionally, though UHS can see medical reports from the hospital, the hospital cannot see reports from UHS.

“If you come into (UHS) with a broken wrist at 10 o’clock on Monday morning, and then you’re transferred to the hospital on Tuesday night, they currently cannot see our X-rays,” Winfield said. “And they cannot see what we did.”

According to Winfield, the current system negatively affects the UHS’ patient care.

“This is kind of an old system that, based on the technology we have now, is begging to be fixed,” he said. “We’ve been aware of it, and we’re absolutely certain that (the current system) is not optimal use of the funds because of the repetition of testing and the inconvenience for patients.”

In the last few years, UHS directors have considered a number of providers for an electronic health record system, but were worried the systems might not be compatible enough with the hospital to meet the needs of the hospital’s system. Last year, hospital officials announced that the hospital would employ Epic, an electronic health records provider.

Winfield and UHS officials asked to be included in the switch to the new program to ensure quick and clear interactions between the two units, including visit documentation, lab reports and X-rays. He said hospital directors were receptive to the idea, though the integration just happened recently.

Though the price has not been finalized yet, Winfield said the new system will likely cost about half of UHS’s allotted budget for electronic records. Rather than dealing directly with the electronic health record provider, UHS is now included in the University Hospital’s contract with the provider and is charged a fee from the hospital.

When the transfer is made to the electronic system, UHS will still refer to the paper system for patients with complicated health issues or treatments. When enough of a patient’s history is documented in the electronic system, the patient’s paper records will be archived.

The switch will include some processing and infrastructure changes for UHS. Because the electronic system is more meticulous than paper records, the pace and flow of the clinics will be different, and UHS might need additional staff to operate the clinics, Winfield said. For example, one of the changes is that the new system requires UHS staff to enter information such as drug allergies, drugs the patient is taking and the patient’s vital signs.

Winfield added that when UHS directors began looking for an electronic health record provider, they altered their operations to meet the criteria of the system rather than to customize the system to fit their current methods. A large part of the adjustment will be training staff to work with the new system and reorganizing staff to maintain productivity.

UHS Ancillary Services Director Gwendolyn Chivers said the new electronic record system will be especially helpful in the departments she oversees, including the pharmacy and radiology departments. Ancillary Services is already preparing for the switch by digitizing data in the laboratory and radiology information systems.

Though the system had some kinks to work out — like images not appearing in multiple places — Chivers said the new electronic system has been helpful.

“When we did not have an electronic radiology system, there was a gap in the continuity of care,” she said. “Now, a patient can go anywhere in the University system, and for continuous care, reports of the images are available, and that has been a tremendous effort but a successful one.”

Correction appended: A previous version of this article misidentified the electronic health health records provider, Epic. A previous version of this article also incorrectly stated when the new system will be implemented.

Leave a comment

Your email address will not be published.