Columbia Program Helping Nation Transition to Electronic Health Records
If you’re a doctor ready to move from paper to electronic health records, Frances Morrison, MD, the program director of Columbia’s Health IT Certificate Program, has a few words of advice.
“It’s not like ordering a word-processing program, installing it on your computer, and spending a few hours figuring out how it works,” Morrison says. “It’s a bit more complicated.”
Successfully implementing a computerized system requires knowing a little about programming, business practices and data privacy – and a lot about new regulations for doctors with Medicare and Medicaid patients about when to implement, and how to meaningfully use, such systems.
And then there’s the clinical know-how necessary to ease computerized records into the workflow of clinicians, and the people skills needed to accommodate a variety of users, from the computer savvy to skeptics.
“Essentially, we need a whole new workforce to liaison between clinical users and the programmers who create the systems,” says Morrison. “We can’t just give clinicians electronic systems and tell them to change their ways.”
The U.S. Department of Health and Human Services has also recognized the need, and last year provided funding for Columbia and eight other universities to develop programs to train such workers. The first class of students to complete the six-month Health IT Certificate, including 51 at Columbia and 26 at a sister program at Cornell, graduated this June.
“Information technology will be transformative for health care in America,” said the government’s national coordinator for health information technology, Farzad Mostashari, MD, ScM, as he addressed the graduates. “And as health IT adoption increases across the country,” the new workforce will play a crucial part "by helping providers become meaningful users of health IT.”
Improving Health with Electronic Medical Records
The potential for health IT to improve health care is huge, says Morrison. “One of the biggest improvements will be helping providers with preventive care, like annual flu vaccines. Paper records can’t send you a reminder, but an electronic system can.”
For Kyle Nielson, who just graduated from the Columbia program and manages a small primary care practice outside Salt Lake City, electronic records gives his doctors more time to spend with their patients. “That’s what excites them the most, and hopefully it will lead to better care.”
The potential to use data from electronic records to improve patients’ safety, identify the best treatments, and spot infectious outbreaks earlier than ever before is what drew Maude James, a registered nurse with 15 years of health care experience, to the field.
“It’s not just about your doctor putting your health information on a computer instead of a piece of paper,” she says. “When that data is collected and analyzed, the possibilities to improve health care are endless. I was considering a job as a nurse educator, but I thought health IT has the opportunity to make a bigger impact.”
Largely through projects that the students completed in teams, the Columbia Health IT Certificate program gave James and Nielson the skills necessary to transform a paper-based practice into a smoothly functioning computerized practice.
One month into the program, James was hired to help implement and manage computerized records at a Long Island hospital.
“The programmers don’t understand the clinician’s needs,” says James. “But when I talk to a resident, a nurse or an attending, I understand what they want, and then I write specifications for our programmers based on clinical needs. Then we test the program with our clinicians to see if it fits in with their workflow.”
She says her transition to her new job has been a great success, in large part because the Columbia program replicates her real-world work environment, where she works with many people with different backgrounds.
“Health IT is the way of the future,” says Curtis Brien, a prospective payment services coordinator at an inpatient rehab facility and another graduate of the Columbia program.
“It’s like any new technology. First people resist it, but before you know it, you won’t know how you lived without it.”
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