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Electronic Medical Records Catch On In Oregon


From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

This year, the federal government gave billions of dollars of stimulus money to medical providers to help speed up their use of electronic health records. The idea is for doctors to coordinate care better so that patients can see their charts online, and to allow clinics to grade their doctors.

Oregon is ahead of the curve. Sixty-five percent of clinicians have electronic medical records, compared to about 45 percent nationwide.

Kristian Foden-Vencil, of Oregon Public Broadcasting, took a look at how doctors are adapting to computers in consulting rooms.

KRISTIAN FODEN-VENCIL, BYLINE: At the Gabriel Park Family Health Center in suburban Portland, Dr. Brett White is sold on his computer. He's had it for about three years now.


FODEN-VENCIL: Today, he brings up the records for his patient, Bill Doctor. Yes, his last name is Doctor, who is here for a check-up.

DR. BRETT WHITE: I mean this is fantastic. This is really exactly where your blood pressure should be all of the time.

BILL DOCTOR: And the only thing I did - I did something conscious. And that was I stopped salting things.

FODEN-VENCIL: The patient, who is in 70s, says seeing his details on a computer is much better than the old paper charts.

DOCTOR: It's an instant look back and especially the historical work. Dr. White, just pointed out and I went, yeah, yeah. And then I could say, well, you know, this is where I started taking the blood pressure medicine. And for me it's great.

FODEN-VENCIL: Dr. White remembers his own Aha-moment, when his new computer started flagging patients who'd been diagnosed with chronic diseases, but then who hadn't been seen in a couple of years.

WHITE: And it was really, oh my goodness. We really need to reach out to that patient and make contact and bring them in to provide the care that they need.

FODEN-VENCIL: Now, he says, computers keep track of those patients and make sure they get their cholesterol checked on a regular basis; and their blood sugar; and any other preventative measures that will keep them out of the hospital.

Bu, there is a downside, he cautions. He's still working out how to multitask.

WHITE: It's challenging to interface with a computer when you're in a room with a patient. But also, spending a lot of time outside of the room and typing. So, I don't think we've hit sort of the ideal just yet.

FODEN-VENCIL: But the computer records aren't just for doctors and patients. They're also being used to track physician performance. White's colleague, Dr. Scott Field, says they're getting scored on all kinds of criteria, such as: Do they use their computer to prescribe? Do they weigh and measure all their patients? Do they hand out an after-visit summary to the patients?

DR. SCOTT FIELD: And my score card, he gets to look at. And I get to look at his. And my nurse gets to look at mine, et cetera, et cetera. We all get to look at each others.

FODEN-VENCIL: The grades don't dictate their pay. But they are a way to get doctors to improve things like bedside manner. Dr. White cringes remembering his own low grade on getting women to have a mammogram.

WHITE: I think we're biased a bit as clinicians where we think we have a really fantastic relationship with our patients on a one-to-one basis. But to see that there are areas, in some cases, significant areas of deficiency, it was a little disheartening.

FODEN-VENCIL: But White says, once most doctors see how grading can help them improve, they're won over by computers.

Despite the benefits of such computers, they've been a long time coming, says Doctor Tom Yackel of Oregon Health and Science University.

DR. TOM YACKEL: We've been on par with industries such as mining, which aren't well-known for their investment in information technology. And if we compare ourselves to banking or insurance, they may spend two, three, four times as much as health care on information.

FODEN-VENCIL: But now, computers are slowly being adopted, says Yackel. They're generating mounds of data that can be mined to save money and improve patient care.

YACKEL: How well are their patients being immunized against influenza and pneumonia? What percentage of patients have x-rays or imaging of their back that's not considered appropriate for low-back pain treatments? We're just starting to gather that data and figure out how we use it to change practice.

FODEN-VENCIL: For now, the federal government isn't forcing hospitals and doctors to go electronic, but it's offering financial incentives - $27 billion over three years. But eventually, it is expected to cut payments to those who don't jump on board.

For NPR News, I'm Kristian Foden-Vencil in Portland.

SIEGEL: And that story is part of a reporting partnership that includes Oregon Public Broadcasting, NPR and Kaiser Health News. Transcript provided by NPR, Copyright NPR.

Kristian Foden-Vencil is a veteran journalist/producer working for Oregon Public Broadcasting. He started as a cub reporter for newspapers in London, England in 1988. Then in 1991 he moved to Oregon and started freelancing. His work has appeared in publications as varied as The Oregonian, the BBC, the Salem Statesman Journal, Willamette Week, the Canadian Broadcasting Corporation, NPR and the Voice of America. Kristian has won awards from the Associated Press, Society of Professional Journalists and the Association of Capitol Reporters and Editors. He was embedded with the Oregon National Guard in Iraq in 2004 and now specializes in business, law, health and politics.
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