Duke kicks off digital health records plan

Duke expects $500M upgrade of electronic system to reduce costs

dranii@newsobserver.comJuly 17, 2012 

  • Duke named one of nation’s top hospitals Duke University Medical Center has again been named by U.S. News & World Report as one of the nation’s top 10 hospitals. It also was ranked as the best hospital in North Carolina. It was among 17 hospitals out of 4,800 evaluated that earned a place in the magazine’s honor roll at the top of the rankings announced Tuesday. Three other hospitals in North Carolina had multiple specialties that earned national rankings, putting them in the top 3 percent of all U.S. hospitals: UNC Hospitals, Wake Forest Baptist Medical Center and High Point Regional Hospital. The magazine evaluated 16 medical specialties at each hospital to derive the overall rankings. Duke ranked eighth in the country, with 13 nationally ranked specialties and two high performing. UNC had three specialties with national ranking and eight high-performing ones, and was rated third in the state overall. From staff reports

— Duke University Health System is going live Wednesday with the first phase of a $500 million plan to upgrade and standardize electronic medical records at its three local hospitals, clinics and doctors’ offices.

“The crux of what we’re doing is developing a single, seamless, integrated health record across Duke Medicine,” said Jeffrey Ferranti, chief medical information officer. “The tag line we’re using for the project is ‘one patient, one record, one system.’ ”

Duke’s massive investment is part of a tsunami of health records digitization by health care providers nationwide. It’s being spurred by the federal government with the goal of improving patient care and cutting health care costs.

Under the Health Information Technology for Economic and Clinical Health Act of 2009, the federal government is providing $27 billion in financial incentives for hospitals and physicians to use digital health records. Financial penalties will kick in starting in 2015 for those who don’t, according to Bloomberg News.

The UNC Health Care System expects to shift to a systemwide electronic medical records system by next June. Today, UNC Hospitals in Chapel Hill and UNC Health’s Raleigh hospital, Rex Healthcare, have different systems.

Likewise, WakeMed reports that it is “working with a group of physician leaders and hospital administrators to identify and invest in a solution that will provide readily accessible information across all providers and facilities.”

But not all hospitals are expected to meet the HITECH Act’s requirement that hospitals make “meaningful use” of electronic records. Giant consulting and technology firm Accenture estimates that roughly half of U.S. hospitals risk being penalized when enforcement begins in 2015.

Duke says the adoption of a unified digital records system will help it curtail duplicate tests, screens and scans and reduce costs.

Patient care will be improved in a number of ways as well. For example, doctors throughout the Duke system – which includes Duke University, Durham Regional and Duke Raleigh hospitals – will be able to see if a patient is allergic to certain medications. That can be crucial if a patient is brought unconscious to the ER.

Just the act of standardizing its medical records has the potential to improve patient care by virtue of its consistency, according to Duke. Today, Duke has more than 135 different electronic medical records systems.

Duke is installing its system, which it calls Maestro Care, in phases. Phase 1, which goes into effect Wednesday, involves 33 primary care practices. It will take two years for the entire system to come on board.

At the macro level, the unified health records will enable Duke to examine the big picture of patient trends with an eye toward improving outcomes.

Dr. John Marucheck, an internist at North Hills Internal Medicine, a Raleigh-based Duke practice that starts using Maestro Care Wednesday, said he received more than 20 hours of training on the system. He rates its user-friendliness a 9 on a scale of 10 and views it as an improvement over the electronic medical records that the practice has been using.

“We’ve moved up to a comprehensive, powerful and user-friendly electronic health record,” Marucheck said.

The $500 million that Duke plans to invest in Maestro Care reflects “total cost of ownership spread over seven years,” Ferranti said. It includes not only the initial cost of acquiring and deploying the software but also the expense of maintaining and enhancing it over seven years.

The net new investment, after subtracting the cost of maintaining and supporting more than 135 electronic health records systems that are being eliminated, is “a little bit more than $300 million” over seven years, he said.

Duke also could receive tens of millions of dollars in federal funding that will partially defray its investment, Ferranti said.

Maestro Care is a customized version of software from privately held Wisconsin-based Epic Systems, which provides electronic medical records to large health care systems. From the outset, Duke can electronically transmit its Maestro Care records – with the patient’s permission – to other health care providers that use Epic software. And Duke anticipates expanding that capability to non-Epic providers over the next couple of years, Ferranti said.

Other North Carolina hospitals that use Epic software, Ferranti said, are New Hanover Regional Medical Center in Wilmington, Winston-Salem-based Novant Health and Wake Forest Baptist Medical Center.

Ranii: 919-829-4877

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