Electronic medical records are well on the way to becoming the health care industry's standard for tracking patient information and office visits, health care professionals here say.

Many of the newest of these health information management systems allow doctors to share patient information across networks, such as between primary care providers, hospitals, or specialty clinics, and thus have the potential to improve the quality of care for patients, they say.

"I think part of the future of EMR is that we're going to see a lot more doctors' offices using them that didn't have them in the past," says Dr. Glen Stream, chief medical-information officer at Rockwood Clinic PS, the large doctor's group here owned by Community Health Systems Inc., of Franklin, Tenn.

Five years from now, he expects that the majority of Spokane's health-care providers will no longer be keeping paper records and will be using electronic records exclusively.

A U.S. government program called the Health Information Technology for Economic and Clinical Health Act, also referred to as the HITECH Act, recently began offering incentives for clinics that adopt the systems, he says. The HITECH Act was enacted as part of the American Recovery and Reinvestment Act to promote the adoption and use of health information technology systems.

While the HITECH Act currently provides incentives for practices that make the shift to electronic records, it also stipulates that health-care providers who haven't implemented an EMR system by 2015 will receive a reduction in their reimbursement rate from Medicare, Stream says.

Mike Cummins, EMR database manager for Surgical Specialists of Spokane, a specialty practice here, says that as the HITECH Act now stands, those reimbursements would be reduced by 1 percent each year for five years, or until the provider adopts an EMR system.

Stream says, "The reason for that is that EMRs have the potential to improve patient care and safety."

He says that one example of how such a system can improve patient safety involves prescription medications.

An EMR system stores all of a patient's past or existing medications, and when a doctor orders a new one, the system will alert the doctor if there are any potential negative reactions between drugs, based on what the patient is already taking.

Dawn Burpee, office manager for Surgical Specialists of Spokane, says EMRs also make electronically prescribing medications easier, because the information goes directly to the pharmacy, which can reduce drug errors that could be caused by an inability to read a doctor's handwriting.

She says timing is another crucial element that's addressed by EMRs.

"Timing can be critical in the medical field, and electronic connectivity is key," she says. "We have the ability to send real-time tasks and data about the patient to another doctor, hospital, or a lab. If we are all connected electronically, it is more efficient and there's much quicker access to data."

Experts here say another potential advantage to implementing electronic medical records systems is the potential for health-care providers to take a more preventive-care approach in their practices.

Jac Davies, director of the Beacon Community for Inland Northwest Health Services (INHS), says, "The advantage of EMRs is that they allow doctors to do a much better job of tracking information for the patient and getting preventive reminders."

One feature of many EMR systems is the option for health-care providers to use preprogrammed reminders within the system so they know when to send a notification to a patient when he or she is due for screenings or tests, such as a mammogram or cholesterol test.

The Beacon Community is a federally-funded pilot program that seeks to link different EMR systems at various health-care providers' offices within a medical community so physicians can share patient information securely with other clinics and doctors to ensure that patients who may be seeing multiple doctors receive consistent care.

Medical offices and hospitals in Eastern Washington and North Idaho make up one of 17 Beacon communities across the country selected by the U.S. Department of Health and Human Services to serve as a pilot for the eventual wide-scale use of health information technology.

"If you think about how health-care in this country has been delivered forever, it's delivered in a single doctor's office, and it's gotten more and more fragmented over time," Davies says. "A patient may go to a specialist one week and another doctor the next week, and it's difficult for the patient to have consistent care and continuity of care."

This is where the Beacon Community's technology of helping connect different providers' EMR systems comes into play. Beacon's essential technology, called a health-information exchange, takes information entered into a specific EMR system and uses algorithms to allow the information to be shared between systems that aren't compatible, says Tamitha Anderson, a spokeswoman for INHS.

"It's sort of like the way a PDF document works; you can create documents in a way that multiple systems can see and use," Anderson says. "The idea for the health-information exchange is to create that common language so the EMRs can use the information in the same way."

Davies says the Beacon Community's technology currently is being tested by providers who treat patients with diabetes because such patients need continual tests and health monitoring and also often see multiple care providers on a frequent basis.

"It gives additional tools to physicians so they can make sure their patients are getting the tests they need for diabetes," through a built-in function in the EMR system called clinical decision support, she says. That tool includes programmable alerts doctors can use to make sure the patient is regularly going to preventive appointments when they're due.

Many Spokane-area health-care providers were using electronic medical records systems well before the Beacon Community pilot program began, including Rockwood Clinic. Stream says it's been using an electronic system for about five years now.

Since the implementation of the system at Rockwood, Stream says the clinic's providers also have begun using the clinical decision support feature to monitor diabetic patients for preventive tests and screenings, and also use the feature for non-diabetic patients.

"It serves as an aid in assisting the doctor in making sure they're doing all the things the patient needs," he says. "If they come in for a cold and haven't had a mammogram or colonoscopy, we can remind them of those things to help them maintain their health."

Surgical Specialists of Spokane, located in the Sacred Heart Doctors Building, was one of the area's first specialty medical offices to implement an EMR system back in 2004, claims Craig Hult, the practice's administrator.

"It was very challenging," he says. "We implemented it in a very short amount of time—six months—and this is a process that could take up to two or three years. It's very time consuming and resource intensive both in staffing and financially; it's very expensive."

Hult says the cost to implement an EMR system is what prevents many smaller clinics here from making the transfer from paper charts to electronic-only records.

He adds that Spokane's medical community is not ahead of the national implementation rate of EMR systems, but isn't behind, either.

While electronic records are generally more secure than paper charts that sit on an office shelf, health-care professionals agree there are still risks, but that they do their best to ensure information remains private.

Says Burpee, "We have very stringent privacy and security requirements that include multiple layers of protection ... All of our employees are assigned a personal password and when they sign on to a system, an electronic trail is left for every record or chart they access, including the date and time they accessed it."

Rockwood uses a similar encryption and tracking method to ensure that records are only seen by those who are authorized, Stream says.

Since implementing its EMR system, Stream says Rockwood has eliminated several on-site storage facilities for its paper records, and has also cut costs in paper usage and extra staffing that was often needed to transport charts from one of its offices to another, if a patient saw multiple physicians.

"The systems we have now aren't perfect, but in five to ten years from now not only will all doctors be using EMRs, but by then the systems will be better because there will be more users ... so the prospects for the future are pretty good," he says.