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Middlebury Providers Get Connected

Work is underway to turn the Middlebury area into one of the most connected communities in Vermont, when it comes to medical records. By early 2012, Middlebury residents will experience the seamless transfer of information between their physician’s office and Porter Medical Center, increasing efficiency and improving patient care.

Porter Medical Center and the 11 physician practices owned by the hospital have started the process of converting their existing computer systems, or in some cases paper medical records, to an integrated electronic health records (EHR) system. The new Meditech system is being installed in phases, beginning with financial and other management functions at the hospital. In August 2011, many of the hospital’s clinical systems will be converted. In early 2012, the physician practices will switch over, completing the transition.

Once the new system is in place, emergency department personnel won’t have to spend precious time looking for a patient’s chart, says Marilyn Olejnik, Porter’s chief financial officer. There will be fewer phone calls needed to primary care physician offices to gather information, and emergency department physicians will know immediately what medications their patients are on. “It does really improve the patient care when they come in the emergency department,” she says.

“Having information from primary care physicians in front of them means the emergency department physician will spend more time with patients,” and less time on the phone trying to gather information, says Denis Mailloux, Porter’s information technology director. Eventually patients will be able to use a web-based portal to view their own information, he adds.

At the physician offices, patient registration will be easier, says Christine Mulholland, office manager at Bristol Internal Medicine. Patients won’t have to present their insurance information at each office they visit, she says. Nor will they have to fill out a medical history at each new location. That and other information will be shared across practices and with the hospital. “If we were to send them to the emergency room, the emergency room would have a list of their medications, a list of their problems, their immunization status.” The latter is important because physician practices now receive many telephone inquiries from hospital personnel asking when a patient last had a tetanus shot or a flu vaccination.

Middlebury area physicians do provide coverage for each other on nights and weekends, Mulholland points out. The integrated EHR system will enable physicians to access patient information immediately after hours, even if the patient has not been seen in the practice before. “That’s going to be huge, patients will get better care after hours,” she says.

While the benefits of sharing patient information are many, patients will have control over whether their information is accessible. “The patient’s privacy is our utmost concern. If a patient chooses not to share their record, they have that right and that restriction will be put on that record,” Olejnik explains.

Porter Medical Center and its physician practices are being assisted in the transition by Vermont Information Technology Leaders, Inc. (VITL), a non-profit organization located in Montpelier that helps Vermont health care providers with health information technology. VITL receives funding from both the state and federal governments to carry out its mission.

Priscilla Phelps, one of VITL’s implementation specialists, is spending two to three days a week working with Porter’s team on the project. “There is a constant flow of emails and questions,” she says. VITL has been able to provide the Porter team with guidance about how to proceed, and what potential pitfalls to avoid.

For example, VITL alerted Porter’s team to the importance of designing databases so that information sharing between the hospital and the physician practices will be easier. As a result, the team changed some of its earlier approaches so that now the system will be more tightly integrated.

Other assistance being provided by VITL includes mapping out workflow processes and determining where interactions between the hospital and practices take place, developing detailed training plans, and documenting computer hardware requirements.

Another VITL team is working with Porter’s staff on building the computer interfaces that will be used to transmit information between various sites. VITL is helping Porter’s staff with achieving the criteria for a federal incentive program that will help pay for the new EHR system. This includes assessing potential risks and developing plans to mitigate them.

VITL’s help has been valuable, says Mulholland, because VITL’s experienced staff members “have the big picture. They’ve been through this before, they understand the process.” The task of switching to a new medical records computer system can be very overwhelming, she adds, but VITL has provided a roadmap and helps keep everyone on track.

Not every physician practice in the Middlebury area is hospital-owned. For example, Middlebury Family Health and Rainbow Pediatrics are independent practices in the process of implementing their own EHR systems, which are from different vendors than the hospital’s system. VITL is working with those practices and others to help them implement their EHRs and communicate electronically with Porter and its practices. This is being done through the Vermont Health Information Exchange, a secure network for Vermont health care providers operated by VITL.

Besides linking the Porter organization to other Middlebury area health care providers, the Vermont Health Information Exchange will be used to send information to other parts of the state, such as when a primary care physician refers a patient to a specialist, or a Porter patient is transferred to Fletcher Allen Health Care in Burlington. The ability to transmit information electronically will save time and cut down on follow-up phone calls, Mulholland points out.

While the work to connect Porter and Middlebury-area physician practices has been generally going smoothly, a few bumps along the way are normal for a project this big and complex, says Mulholland. “VITL prepared us for that. They said, ‘you are going to have good days and you’re going to have bad days.’ It’s good to have that support from VITL.”

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