Mediformatica - The Medical Informatics Portal

The Ochsner Clinic opened its doors in 1942 and remained a New Orleans specialty-based practice for more than 40 years. During that time, each patient had just one medical record to which all physicians contributed. In those early years, patients’ complete clinic records accompanied them to their appointments, and care providers had ready access to everything known about them. By the early 1980s, the clinic had grown to more than 350 physicians, primary care neighborhood clinics were developed in New Orleans, and a multi-specialty practice was established in Baton Rouge. Suddenly patients might have their medical record broken into pieces — a different piece in each clinic where they were seen.

The Next Step

The clinic deployed automation to support registration, appointments and billing in the mid-1980s. Because each Ochsner patient was given a unique “clinic number,” it was easy to know which clinics housed pieces of their chart. An automated chart tracking system was created so any piece of any patient’s chart could be easily located and retrieved as needed. It proved cumbersome, however, to move charts across town or between cities, and most care was provided without access to the entire record, or sometimes even the most relevant of the pieces.
A group of physicians was determined to improve this situation by building on the new practice management system and using its computer terminals, which by now were widely available. Thus, the Ochsner Medical Information System (OMIS) (which today remains an important part of Ochsner’s Electronic Medical Record (EMR)) was born.
The first OMIS application was the Medical Database. Consisting of a chronology of procedures and diagnoses extracted from encounter transactions, the MDB enabled physicians anywhere to see when and where care was provided, who provided it, and why. Since at that time Ochsner patients received most of their care at the clinic, this information was leveraged to provide an effective health screening and reminder system.
Because Ochsner has its own laboratory, radiology and other ancillary services, it was relatively easy to provide access to ancillary results through OMIS. By 1990, interfaces from the laboratory information system and transcription systems populated OMIS with all laboratory and radiology results as well as hospital transcription. In addition to making results ordered anywhere in the Ochsner system available for all, OMIS virtually eliminated redundant testing.
During the next several years, emergency physicians at Ochsner created an electronic emergency department charting system. All of the emergency physicians, as well as house officers rotating through the department, created all of their notes using automated documentation tools. All emergency department notes were stored in OMIS, and thus became immediately available to clinic physicians when patients returned for post-emergency care.

 

The End Result

Because OMIS was able to deliver ancillary results, emergency department notes, and hospital transcription reliably and electronically to clinic physicians when and wherever it was needed, by the mid-1990s “the computer” became an essential feature of Ochsner’s clinical practice. Today, all Ochsner physicians practice with complete electronic medical records.
Ochsner’s EMR had its origins in an environment where needed patient health information was difficult to access. In our geographically distributed practice where clinic physicians share in the care of patients, the EMR has once again re-established a single, consolidated record for each of them, and its value is widely appreciated.

Get the full article http://www.healthdatamanagement.com/issues/2008_48/EHR25841-1.html?CMP=OTC-RSS

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