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Detroit Medical Center "fills in gaps" for paperless system

By Molly Merrill , Associate Editor

Detroit Medical Center's chief medical information officer says the system, which has 2,000 licensed beds, is working on "filling the gaps" in its electronic documentation as it strives to meet ctory/meaningful-use" target="_blank" class="directory-item-link">meaningful use and become paper free. DMC is hosting an educational session at HIMSS10 in Atlanta on Wednesday that will document the system's IT journey to a Stage 6 on the HIMSS Analytics' EMR Adoption Model.

DMC's session is titled: "Getting to Stage 6: Lessons Learned from an Urban Medical Center," and will feature Mike LeRoy, DMC's senior vice president and chief information officer, who will discuss the lessons learned and methods used to manage implementation and application performance.

"Reaching Stage 6 EMR adoption is a great accomplishment, but was not an easy task and quite a journey," said LeRoy. "I look forward to sharing this story with my peers at the HIMSS 2010 Conference and to provide some valuable insight and advice to those going through this implementation process."

According to HIMSS Analytics, DMC is the largest U.S. healthcare system to reach Stage 6 of the EMR Adoption Model.

It is DMC's intent to reach a Stage 7 sometime in the next calendar year, says Leland A. Babitch, MD, the system's CMIO.

"We are talking about eight hospitals here," said Babitch. "So this has to be a system-wide change, and it could take a little longer."

Leland said DMC began rolling out a clinical documentation system in Dec. and only a couple months into it 25 percent of its inpatient base is already receiving electronic notes. He says they are seeing a 20-30 percent increase in electronic documentation month over month. However, getting everyone on board will be the system's greatest challenge due to the number of specialists and private doctors. It is even tougher than CPOE because notes are done so frequently, he said.

"There is so much nuance in notes because there is no standardization and that makes it a bigger leap," Babitch said.

In DMC's ICU, nursing documentation is still paper-based, and a successful move to an electronic system, "will hinge on the ease of getting that highly technical vital sign data from the monitor and onto the computer." He says this is not only time consuming for nurses but can increase the likelihood of transcription errors.

"I think it is a bigger step to get from Stage 6-to-7 than from Stage 4-to-5, or Stage 5-to-6," said Babitch.

Although Leland views the HIMSS Analytics EMR Model as a good standard, he says requirements for meaningful use could "muddy the waters a little."

"They are mutually exclusive so it is going to make it harder to pick one versus the other. It falls down to what is right for the system or the patient instead of trying to meet one single goal," he said.