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N.D. leads nation in electronic medical records use

Dr.Joanne Gaul, a family medicne doctor at Altru Health System in Grand Forks, checks a patient's medical record on a computer in her office. A study by the Centers for Disease Contro and Preventionl reports that 82.9 percent of North Dakota doctors use an electronic medical records system. the highes in the nation.JOHN STENNES/GRAND FORKS HERALD

In North Dakota, medical records are more likely than other states to be stored electronically rather than in a paper folder.

A report this month from the national Centers for Disease Control and Prevention said North Dakota health care providers are ahead of the rest of the country in adopting electronic systems to manage patient records.

According to the report, 82.9 percent of North Dakota’s office-based physicians use a basic electronic health record system. The next highest rate was in Minnesota, with 75.5 percent. New Jersey’s rate was the lowest, at 21.2 percent.

“I think North Dakota definitely sets an example for others to follow,” said Alex Todorovic, manager clinical applications for Altru Health System.

The CDC study follows up on incentive programs through the federal Centers for Medicare and Medicaid Services, known as CMS, that gave financial incentives, funded through the 2009 stimulus program, to hospitals to adopt electronic records systems.

The study defines a basic records system as one that allows doctors to access patient history, demographics, patient problems, clinical notes, medications and allergies, test results and other information.

The national average for adoption of basic systems was 48 percent in 2013. The average for doctors using any type of electronic records, other than for billing, was 66 percent.

North Dakota is part of a cluster of states with significantly higher than average adoption, including South Dakota, Minnesota, Iowa and Wisconsin.

Mark Waind, administrative director of Altru’s information services, said North Dakota’s low population may have facilitated the adoption.

“One reason is we’re a little more rural than the rest of them,” he said.

One big system

Altru uses the Epic software system for its records management, a purchase that came with a roughly $28 million investment.

“It was a huge decision for this organization,” Waind said. “I can honestly tell you the system has paid for itself” in improved efficiency and incentives from CMS.

Around that time, money was available through the federal American Recovery and Reinvestment Act, and other larger hospitals in the state were adopting the same system, he said.

Epic allows regional health care systems like Altru to make it available to rural medical centers at discounts as much as 85 percent. With many of the state’s larger hospitals using the system, it has spread to the small providers that usually funnel patients to them.

“I can think of a number of facilities in the state that have done the same thing,” Waind said. “This allows us and allows them to get a first-class system.”

The widespread use of electronic records also helped the state to be ahead of its peers in establishing the North Dakota Health Information Network to allow providers to share records more easily.

“A lot of states have multiple organizations vying for that role,” Waind said.

Efficient treatment

Along with CMS incentives for electronic records, there has been an industry-wide push to go electronic, an area in which health care has lagged, according to Waind and Todorovic.

Electronic records are believed to reduce error, inefficiency, redundancy of treatment and make vital information more readily available to doctors in deciding treatment.

“You eliminate a lot of these steps where something could have been transcribed incorrectly,” Waind said.

The Epic system also allows patients to access their own records, test results, appointments and medical bills through the online MyHealth tool. CMS’ electronic records incentives mandate greater patient involvement in their care, Waind said.

He had the chance to see the benefits of electronic records first hand when on vacation in Minnesota last summer, he said.

Feeling sick, he visited a clinic that is part of the Essentia Health system in Detroit Lakes. Though it was a facility in a different town and different provider system a staff member there was able to access his records through the Epic system.

“Just imagine a more acute encounter,” Todorovic said. “When every second counts, it can literally make the difference between life and death.” 

Christopher Bjorke

Christopher Bjorke is the content editor for the Grand Forks Herald. He first worked for the Herald in 1997 and most recently since 2011. His jobs at the Herald have included covering local government, state politics, business and economics, and the health care industry. 

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