Medical records are something few people think about until they don’t work well.
But when records don’t transfer easily between health providers, it can be a huge headache for patients, resulting in delayed doctor’s appointments, repeated tests, miscommunications, and, perhaps worst of all, fax machines.
“Oftentimes it ends up being a paper process, and there’s a lot more work and delay in care that can happen,” said Adam Sanborn, a primary care doctor at Kaiser Permanente’s Kendall Yards office.
Spokane has struggled with portable medical records, in part because the region’s two largest health systems, Providence and Rockwood, had different programs.
While information about emergency room visits or clinic care can be transferred between the two, it’s not automatic – which means a patient going in for a follow-up appointment might be talking to a doctor who’s missing test results from their recent hospital stay.
Starting June 1, the former Rockwood system, now called MultiCare Spokane, will run entirely on Epic, the same program used by Providence and Kaiser Permanente. Patients may know it as “myChart,” a web-based program they can log in to to see test results, schedule appointments and refill prescriptions.
MultiCare executives said the company has invested more than $25 million in the switch, which they said will improve patient care and satisfaction while making life easier for provider in and outside their clinics and hospitals.
The goal? “One patient, one record,” said David O’Brien, MultiCare’s senior leader for the Inland Northwest.
MultiCare clinics in Spokane have already made the switch over a two-week period starting in early March. That meant converting 375,000 patient charts and 25,000 future appointments, said Alex Thoreson, a consultant working with MultiCare to get the new system up and running.
The Tacoma-based health provider has been using Epic in its West Side clinics and hospitals for years and brought medical staff from there over to help train Spokane providers on the new system.
Patients will benefit from new features in Epic, including a better online appointment scheduling system and the ability to refill controlled substances prescriptions online rather than getting a handwritten note from a doctor.
Under the old system, “if they run out … on the weekend, there’s no way,” said Brenda Bowles, MultiCare’s director of clinical informatics.
Even patients who got all their health care through Rockwood clinics and hospitals should see an improvement. Before switching to Epic, the clinics used one records system and the hospitals used another.
“In the past, the system wasn’t very efficient,” O’Brien said.
Other providers in the area, including Providence, Kaiser and the Spokane Fire Department, say the transition is good news for them.
Sanborn said he’s found it much easier to get patient information from Providence as opposed to the old Rockwood system. And delays, even of a few hours, can change patient care significantly.
If Sanborn needs test results from work a patient had done in a hospital and can’t access records quickly, it can lead to duplicate procedures.
“Sometimes I may have to repeat labs when they may not have been absolutely necessary,” he said, because results are sometimes needed immediately to guide drug prescribing.
In other cases, it might mean he has to go over important health information with a patient over the phone, rather than when the patient is in his office for care. He always prefers in-person conversations because it’s easier to get questions answered.
“You can make sure the understanding’s there,” he said.
In a statement, James Reggin, Providence’s director of medical informatics, said the switch would mean “a better, more seamless experience for patients receiving care between participating health systems in our region.”
Even for providers who don’t use Epic, having the region’s major hospitals on the same system makes it easier to build records that can talk to each other.
Mike Lopez, the Spokane Fire Department’s health services manager, said paramedics can use a linked records system to send information to hospitals as they’re caring for a patient, preventing delays when that patient is transferred to a hospital.
“Five to 10 years ago, we’d walk in with a hard piece of paper we’d been writing on and say, ‘Here you go,” Lopez said. With hospitals using Epic, it’s easier to preregister patients before they arrive at the hospital.
The fire department is working on a system to better share information with local hospitals, including allowing first responders who provide care to learn about patient outcomes once they get to a hospital.
Lopez said it will be easier for first responders to see when a local hospital is diverting patients because they don’t have bed space and transport people to hospitals that aren’t full.
MultiCare Spokane’s new records will go into effect at Deaconess and Valley hospitals just after midnight on June 1, which project workers hope will give them a few hours to sort out bugs when the hospital is less busy.
“We call it the big bang,” Thoreson said.
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