Sunday, August 1, 2010

HIT Helps Small Community

Frank Vozos, M.D., Executive Director of the Monmouth Medical Center located in Long Branch, New Jersey, appeared on July 27th before the House Energy and Commerce’s Subcommittee on Health to highlight how the medical center’s use of HIT is helping in Long Branch, a small community on the Jersey shore.

He told the Committee that the Monmouth Medical Center (MMC) a 527 bed community teaching hospital provides a full spectrum of services from neonatology to geriatric care. The Center has more than 800 medical and dental staff members admits more than 22,000 adult and pediatric inpatient, as well as cares for over 120,000 outpatients annually.

He explained that the hospital is the leading healthcare provider in Long Branch, a multi-ethnic enclave of residents who are disproportionately poor, young, uninsured, and members of minority groups. More than 35% of the city’s population lives at or below the Federal Poverty Level. There are four census tracts within the city that have been federally designated as Low Income Medically Underserved Populations.

Although there are 40 primary healthcare providers located in the area, most do not accept Medicaid or offer charity care. As a result, the medically indigent population in Long Branch and the surrounding communities use low income clinics provided through a FQHC and the Emergency Department at MMC as their only source of healthcare.

However, the 150 acres that includes the Long Branch oceanfront has added more than 1,300 high end residential properties and 600,000 square feet of commercial space in the near vicinity of the medical center. Residents in the oceanfront area are mostly “empty nesters” and as they grow in both numbers and age, they will place an increased demand on both emergency and other health services in the area.

Dr. Vozos told the Committee that MMC installed their first electronic clinical information system in 1988. Since that time, the Emergency Department has invested significant resources and installed sophisticated IT components. For example, the hospital has a direct electronic interface between the ER clinical information system and hospital charts using the EDIMS computer framework. All records and tests link to the hospital EHR system.

MMC’s clinical information platform connects data from devices that comes from either local or remote workstations. The data goes to the EMR and to providers to enable telemedicine to be used so that better patient care can be delivered. This interconnectivity allows data to be sent and received as well as safely stored based on CCHIT HIE specifications. The medical center is very focused on CPOE and is trying to encourage the physicians to enter orders into a computer instead of handwriting them.

MMC is encouraging physicians to take advantage of EHR systems in their own practices and to be able to interface with MMC so that by 2011 there will be active physician connectivity. The medical center is looking into the costs associated with linking physicians to the medical center by examining what can be subsidized, what can be funded by the medical center, or funded by physicians to work towards connectivity.

According to Dr. Vozos, the Medical Center along with two other hospitals in N.J are beginning a CMS funded 21 month pilot project to test a model to be able to transition Medicaid patients who come to the Emergency Department with non-emergent care needs to the appropriate primary care setting through collaboration with the FQHC. This data driven pilot will integrate electronic referral systems and EHRs, improve the infrastructure, and coordinate the pilot in N.J and in 19 other states.