HOSPITAL administrators are singing the praises of the new electronic health records (EHR) system which they say has led to greater efficiency in public health facilities, with wait time for some services now cut in half.

Three facilities — May Pen Hospital, Spanish Town Hospital, and St Ann’s Bay Regional Hospital — are now actively using the system, following its official roll-out in January. Thirteen health facilities are slated to benefit under the first phase of implementation.

With a ‘one patient, one record’ philosophy, the system entails the transition to a paperless system for patient records and the uploading and sharing of these records among health-care providers for the seamless and collaborative delivery of care.

The EHR’s features, which include a patient registration system for appointment setting and assignment of patients in the triage process of a facility, has resulted in shorter wait times for patients; less cost in providing services; increased productivity; reduced staff frustration; and increased service satisfaction levels.

Implementation of the system was initiated at May Pen Hospital in January, with the test phase beginning in November last year. The hospital’s resident, general surgery, and system specialist for EHR Dr Gary Thompson told last week’s Jamaica Observer Monday Exchange that the staff was excited that the hospital was the first to come on board with the new system, which has led to many benefits.

“There are short-term benefits that we’ve already seen in terms of access to the records, the time that it is taking to see the patients because the access to the record is reducing the time, and then once you’re going into those records, you’re able to get the information about the patient more quickly and in a more streamlined way,” Dr Thompson said.

“So, for instance, there are bits and pieces of information that we access in terms of assessing our patients, like using the blood pressure, and if we want to see, for instance, the trend of the blood pressure over a period of time, that information is just readily available.

“Previously, we would have to skip through your nurse’s notes, going back to yesterday, the day before, to see what it’s been like. But now it’s mightily easy,” added Dr Thompson.

He said that getting patients’ records now takes just seconds, which has made a huge difference in the outpatient department where previously patients would sometimes become frustrated because they would come in early but sometimes see other people getting through before them.

“What really happened is that the health records staff might have had some issues finding that file, so by the time that file is found, they end up a little later down on the list. That problem has been eliminated, because once you’re on the system we’re able to create a queue that says this person came this time, that person came that time, and that eliminates that problem and also the delay that it will take in terms of trying to find that file. When that patient has been coming from a rural area — when they’re there from six o’clock, five o’clock, sometimes just waiting because they want to get through quickly — and all of their efforts have just gone to naught because there was an issue just finding the records, that’s not the challenge anymore,” said Dr Thompson.

He noted, however, that the only hiccup is that some patients’ records may not have been loaded to the system as yet, especially if they have not visited the hospital from before November last year.

In the meantime, Spanish Town Hospital’s Senior Medical Officer Dr Jacqueline Wright-James said her team is also very happy with the level of efficiency the electronic system, which went live at the facility on May 17, now brings.

She noted that training began in October last year with more than 800 medical para-medical staff.

“We started with our clinics, and to see how the patients were so happy. The first clinic that we started was antenatal… I would have to speak anecdotally because we have not really done the figures yet, but I can say that… our antenatal clinic would see roughly 300 patients per clinic and that normally would take us about four hours to run that clinic. Now we’re finished the clinic within two hours,” she said.

Dr Wright-James said, as well, that more than 30,000 patients were seen using EHR in the Accident and Emergency Department (A&E) and a similar number in the clinics. “So even for maternity, we would have had at least 500 deliveries recorded on the electronic health records since we have started,” said Dr Wright-James.

“The team is excited, the nurses say, ‘Doc, I don’t have to fight for the records anymore,’ because one of the things it also allows is when we have a patient who has a multi-disciplinary [case], so the physiotherapist is coming, the dietitian is coming, the doctors from different departments are coming. We don’t have to wait for that one hard record anymore. Everybody can access the record at the same time for the one patient. So this thing that we have going — one patient, one record — is really one patient, one record,” added Dr Wright-James.

She said another advantage of the EHR is the interoperability of the system, whereby the health records of patients are now linked, so their data would already be at the hospital when they come from other facilities.

The EHR system allows health-care providers access to review a patient’s full medical history via a database, whether at a health centre or hospital.

Other features that help to make that possible include a seamless interface of critical diagnostic imaging that will enable health-care professionals to see X-rays and CT scans on computers and tablets provided within the facilities.

“With the electronic health record, we can have data at our fingertips now. I can go on there and tell you how many patients, instead of counting; I can tell you how many patients came to A&E today, and, of course, we have to use the data to improve. Data is what drives a lot of our decisions. So there are so many advantages to the EHR. When the patient comes, and for some reason they’ve forgotten the long list of 10 medications that they’re on, the electronic health record [can solve that] because that was a problem before,” Dr Wright-James said.

Medical technical liaison at St Ann’s Bay Regional Hospital Dr Debbie-Ann Morgan, who said the hospital is to go live on September 23 following the completion of training, foresees many of the benefits that May Pen and Spanish Town hospitals have already realised.

“We are excited and looking forward to seeing a lot of those benefits. Some of the problems they would have had before we are expecting to see eliminated as they have said. The system is very user-friendly. Doctors and nurses are finding it very easy to use, very easy to interface with, very easy to apply it. The training is going very smoothly,” said Dr Morgan.

“We’re looking forward to both the long-term and short-term benefits of what it has provided for the other hospitals, especially the fact that our other three health facilities — Ocho Rios, St Ann’s Bay, and Brown’s Town — will be coming on board. And so the inter facility communication will be a lot easier for us and as Spanish Town has said before, it allows us to view their information, so when they are referred to us or we refer them back to the health system we are able to keep abreast of the patient,” she added.

Dr Morgan said she is also anticipating where the application of the EHR in the A&E Department will greatly benefit the hospital “because we will be able to triage the patients more efficiently, the persons who are needed to be seen will be seen more efficiently.”

“So you have maybe one to three persons to triage, they will be able to be seen more efficiently, you will be able to see them on the system. The doctor will be able to view it in a timely manner and persons who are there who…don’t need to be seen in such an urgent manner, they can be quickly picked up by the system and referred back to the health centre. So it gives the doctor more time and the nurse more time to focus on these patients who need more urgent care,” she said.

The EHR is being implemented as part of the Health Systems Strengthening Programme, for which Jamaica has received funding of US$50 million from the Inter-American Development Bank. A portion of that sum was used for the acquisition of the EHR System.

Other facilities to benefit in this first phase are May Pen West Health Centre, Chapelton Community Hospital, May Pen East Health Centre, Mocho Health Centre, Greater Portmore Health Centre, St Jago Park Health Centre, Old Harbour Health Centre, St Ann’s Bay Health Centre, Ocho Rios Health Centre, and Brown’s Town Health Centre.