Fairfield Ledger
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Neighbors Growing Together | Sep 21, 2014

Health center to improve emergency room documentation

By VICKI TILLIS | Sep 25, 2013

The Jefferson County Health Center Board of Trustees approved the purchase of an emergency room documentation computer program during its regular monthly meeting Monday evening.

Curtis Smith and Staci Worley, the health center’s outpatient director and assistant outpatient director, respectively, presented information about the EMRDoc program from EPOWERdoc.

The two explained that Jefferson County Health Center currently uses the CPSI electric health record system, but CPSI does not have emergency-room specific electronic forms. Currently, ER personnel fill out paper forms, which have to be scanned in so it can be placed into a patient’s records.

“There is a lot of inconsistency in charting,” said Smith. “If charting is better, there is better care, better documentation, better coding.”

The EMRDoc program has more than 300 forms. The form ER staff fills out depends on the patient’s chief complaint and age.

Worley said the forms list questions to be asked so it helps guide new nurses as well as those who need help with documentation.

She also said the forms offer more opportunities for coding and reimbursement, and leaves no uncertainty about what level of an emergency was treated, plus certain information has to be documented before a physician can close the file.

The new program includes a tracking board, similar to a television screen, which shows how long a patient has been in the ER, his or her complaint, if test results are back and more.

The program also provides discharge instruction sheets, with color photos, so patients know what to watch for and how to take any medications.

The new program also runs a report every morning and lists the patients who need to be called that day with information, such as test results.

“This is an excellent system, but it has its problems,” said health center CEO and administrator Deb Cardin. “It’s ideal, but if you have this and CPSI, there are interface problems. … But we can’t wait any longer because we need better documentation. I support this because we can’t wait.”

Smith said it would take about six months to set up the new program, and then EMRDoc personnel would come to Fairfield to provide training.

Smith and Cardin both reminded the board members the purchase of the program was not in the budget.

“I think we can probably handle it,” said trustee Tom Kunkle.

According to Smith, the start-up cost for EMRDoc is $291,300. He expects a $218,475 Meaningful Use reimbursement from the federal government, which would lower the start-up cost to $72,845. The annual fee would be $34,300, which would allow upgrades and interfaces.

Plus, he continued, the health center would save $55,000 a year on dictation, so the investment on the program would be recovered in a few years.

Gene Irwin, the health center’s chief financial officer, pointed out the Meaningful Use reimbursement for switching to and using electronic records ends in October 2014. He said he thought Smith’s estimate on the reimbursement was conservative.

“It would be very unwise not to make use of the Meaningful Use dollars,” said trustee Greg Hanshaw.

“It is huge.”

Trustee Merlin Miller motioned to approve purchasing the EMRDoc program, and the board members unanimously approved it.

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