SWMC continues to innovate with electronic medical records

Editor's note: This is the first of a five-part series examining multiple changes and improvements at Sanford Worthington Medical Center since its purchase by Sanford Health five years ago.

WORTHINGTON -Over the last five years, there has been no shortage of changes and improvements at Sanford Worthington Medical Center (SWMC).

Officials at the hospital agree they have Sanford Health to thank. Since the purchase of the facility formerly known as Worthington Regional Hospital in 2008, a transformation of sorts has taken place.

One area in which SWMC has made dramatic advancements is electronic records. The hospital went active with a new electronic medical records system - its first "go-live," said Jeff Rotert, the hospital COO/CFO - in May 2008, prior to its sale to Sanford.

"It came in three big phases and in a lot of other smaller phases as well," Rotert said of the new records system. The next major go-live, he said, was in April 2010, when staff clinical documentation began being entered electronically. The most recent phase was undertaken in May 2012, with the addition of physicians using computer physician order management.

"The physician does all his or her entries - the whole complete chart -electronically," said Jennifer Weg, SWMC's CNO. "The other thing that comes with that as a caveat is remote access. If the patient, for example, has a changing condition after hours, we make a call to the physician to inform him, and he can look at the whole chart electronically from home for better assessment and care plan orders."

Mike Hammer, CEO at SWMC, added that if a patient who regularly visits Worthington has to go to another Sanford facility, his or her electronic record can also be viewed by their speciality physician.

"It used to be that a patient would come into the emergency room and they would say, 'I don't know what medicine I'm on," and the doctor would have to know or find out," Weg said. "Now, that information is at doctors' fingertips in the electronic medical record."

"This has been sort of a national transition over the past five, eight, 12 years," Hammer detailed. "Some hospitals have struggled with affording and implementing these sophisticated medical records. It would have been difficult for us to do this alone if we didn't have Sanford as a partner. It's not just having the system - it's also the constant support building and revising, and all of the different components and functionality pieces."

Life isn't just easier for physicians at SWMC thanks to electronic records - it's also simpler for patients, too, thanks to an innovation called MyChart.

"You can email your doctor through MyChart and you can fill prescriptions, pull up your lab results, make appointments and look up past immunizations," Weg listed. "If I'm an elderly patient and I want my daughter to also be able to go and see what's going on with my health care, I can allow her to have access to my chart, too."

"I think this is very unique," Rotert said. "I don't think there's anything out there similar to what Sanford has at this time with MyChart."

MyChart is available online, and there is also an app available for a number of mobile devices. Also included in MyChart are such amenities as prospective wait times at healthcare facilities and a find-a-doctor feature if one is looking for the nearest specialist in a certain area of care. (A Sanford app is also available for patients.)

While allowing easier physician and patient access to records is important, those improvements just might pale in comparison to what's taken place with the implementation of the Picture Archival and Communication System (PACS).

"PACS is where we store all the radiology images we have acquired," explained Reed Fricke, SWMC Radiology Manager. "It replaces thousands of pounds of images of film.

"We have access to any image that was acquired at a Sanford health facility without having to wait for it to be physically found or delivered," he continued. "Say you get a critical patient - a specialist could be looking at his film as well as a radiologist while in the ED getting care."

"This allows for a very quick turnaround time on interpretation," Rotert pointed out. "We can get an image read right away by the highest level of professional care available, rather than wait for an in-house radiologist."

A radiologist still reads the images, Rotert clarified, but that individual doesn't need to be at SWMC - he or she can be at a different Sanford location.

No longer is hospital staff relying on film that could get lost or delayed; there are multiple PACS back-ups, Fricke said. And with no need to transport film, digital images can instead be viewed immediately for a much more efficient means of care.

"This is probably the single biggest factor in improving our information technology structure," Rotert said.

Brad Klassen, the regional IT administrator at SWMC, works with Sanford Health in Sioux Falls to ensure the new system runs smoothly.

"New software application demands nearly always drive the need for additional hardware, faster technology, hardware in new locations, and improved IT infrastructure," Klassen said. "For example, the need for bedside charting required the install of PC's in patient rooms and exam rooms -it greatly increased the demand for PCs and laptops and network equipment. The requirement of mobile devices forced the implementation of a wireless infrastructure. Radiology PACS imaging, offsite storage, and the ability to share images with other Sanford entities has required high speed fiber connectivity to Sanford IT infrastructure in Sioux Falls.

"When I started working at the Worthington Regional Hospital about 10 years ago, we had about 40 computers," Klassen added. "Now I work to support over 400 computers at Sanford sites in Worthington."

Yet another component of the host of improvements is in the area of Telehealth.

"We can connect with a board-certified emergency physician in Sioux Falls, and we can connect with a neonatal intensive care unit in Sioux Falls - we also have some specialty physicians that we can connect with in Sioux Falls, such as a psychiatrist," Weg said.

In a sense, this sort of care works a bit like medical Skype - the doctor and patient can see and interact with each other. This sort of technology can come in handy in varying circumstances.

"A great example is when a mom has to stay hospitalized in Worthington, but the newborn is in Sioux Falls," Weg said. "The mom can still see the baby if she can't be there in person."

SWMC doctors can also interact with each other in a whole new way, too. Teleconferencing allows for meetings throughout the system and the elimination of travel time. Also new is Tumor Board, which allows doctors to communicate with their colleagues and discuss a different type of cancer with each meeting.

Hammer, for one, is impressed with all the modernization in technology at Sanford Health.

"I've only been here a little more than a year, but this electronic investment Sanford did is huge," he said. "It just enhances us being part of this system and being able to communicate with all the hospitals - that's really the backbone of pulling the system together. I think most of the smaller hospitals would have had difficulty implementing this, this well, without Sanford Health."