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Extended Interview: Dr. Charles Shepard

Dr. Charles Shepard spoke to NewsHour health correspondent Susan Dentzer about the benefits and bumps along the road in using electronic health records.

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    What's the value to you as a physician having all this information at your fingertips?


    The value is just enormous. Prior to the electronic record, in our community we had separate medical records in three different clinics and the hospital. And information in each one was inaccessible to the other. And so now this is an integrated system. We capture all the information from all three clinics, plus the hospital, and it's in one source. So I can look back and see what's happened at the clinic, I can look back and see what medicines have been taken in the past, what his regular doctor was thinking. If he's been seen at the Mayo Clinic or referral places, those letters and results are all scanned in. So there without leaving my chair, I'm able to access information that was so fragmented that was nearly impossible to get before.


    And you just showed us this entire battery of information in several minutes, a very different time table than in the past.


    Tracking down the chart was primarily with a student nurse in some far room. Once you located the chart, things were pretty cluttered and hard to retrieve, but laboratory information would not have been displayed in a serial way. We could not grab it, we could not follow trends. Now the information is more accessible, it's cleaner, easier to analyze. And the imaging, previously they had to go down to X-ray department if we wanted to actually look at a film. So now we can pull up films ourselves.

    We still have the option of going to X-ray to talk to the radiologist if we wish. But it, for our purposes it's fine most of the time to just pull up the image. I can look up what the radiologist thinks and if we have different views we can go down and talk it over.


    Are you a better physician because of these tools?


    I think so. We've tried to make information available to point of care, and so carrying all the patient information compiled in one place, easily accessible, is a huge advantage. The imaging is an advantage. You also have an electronic medical encyclopedia on line. It's searchable. You can have a couple of books here, one on preferred antibiotics for various situations, and one for adjusting medication in the case of kidney failure.

    So we've never had so much information at our fingertips as we do right now. And I think in the end it leads to better decisions in patient care and more efficiency. As I can see what his previous doctor did in the last clinic so I maybe don't need to repeat that test or that x-ray. So it's a great opportunity and a huge sea change for medicine.

    As part of the computerized provider order entry system in the emergency room, they created a catalog which you can order from and there were 2,500 medicines, 800 imaging tests and 600 laboratory tests. For inpatients, the medicine catalog will probably be 10 times that size, between 20 and 25,000 ordering choices.

    The other thing we have to create is order stats. To enter an individual order takes about 45 seconds which is way too long and so we want to create in a preestablished order stats for individual conditions based on best practices so doctors can select or deselect certain things that makes it go faster. It's also an opportunity for standardized care on the best practices.

    It's really an unparalleled improvement opportunity to develop these order stats and have conversations about what's the best treatment for a condition. So we're expecting to have about 200 of those when we go live and so teams are, are working on that right now.

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