Jul 14 2009

Have Medical Records, Will Travel

VA hospital finds electronic records and mobile devices let doctors and patients gather and access healthcare information on the move.

For Dr. Robbi Venditti, the biggest benefit of electronic health records at the Veterans Health Administration is having complete and on-the-spot access to medical histories of patients, including doctors’ notes, blood tests, X-rays and other medical records that have been scanned in.

A few years ago, a new patient showed up at the Carl T. Hayden Veterans Affairs Medical Center in Phoenix without an appointment and told Venditti that he was from New York and wanted his chemotherapy treatment. Luckily for Venditti, she could access the patient’s health record immediately.

“It’s instantaneous. I could see what he was being treated for, so I referred him to our oncologist who picked the therapy right up where the patient left off in New York,” she recalls.

Her experience with the New Yorker was not isolated. The Phoenix center receives on average 60 new patient requests a day, many coming from other VA hospitals. 

“When they say they came from California and think that the doctor told them that their blood pressure is too low, I can look at their records,” she says. “It makes my job easier and allows me to take care of patients at a much higher level.”

Records to the Rescue

VHA was an early adopter of EHRs, having rolled out an initial system in 1998. Each patient room is equipped with a desktop computer. When Venditti logs in and opens a patient’s chart, it shows a list of preventative healthcare reminders for each patient, such as a need for a mammogram or colonoscopy.

When blood, lab or radiology tests results come in, she gets an alert on the computer system to check the results. VHA also offers clinical practice guidelines that advise doctors on how to treat common health conditions, such as diabetes, hypertension and heart disease.

“There’s less chance of any omissions or errors,” she says.

The medical center also has moved point-of-care technology out to its patients’ homes. It provides 270 patients with mobile devices that remotely transmit blood pressure, weight and other vital information over their home phone lines and onto the hospital’s computer system every day.

The service, launched in the early 2000s, lets hospital staff monitor patients with chronic diseases without patients having to drive to the hospital, says Rose Buckle, nurse manager for the VA Medical Center’s telehealth program. Of its 270 patients, one-third have diabetes, one-third have chronic obstructive pulmonary disease and one-third have congestive heart failure.

“It’s a high-tech way to monitor patients,” she says. “We look at their results and intervene, if necessary, and tell them, ‘You need to increase your insulin.’ It prevents a crisis. We can keep them better controlled, and they feel more secure that someone is watching them.”

Patient-Gathered Data

The VA telehealth program echoes a growing healthcare trend, says Gartner analyst Barry Runyon. Because of advances in medical, mobile and wireless technology, the point of care has now moved from a patient room in a hospital or clinic to wherever the patient is located — at home or even on a battlefield. The U.S. military, for example, has used video conferencing so doctors can remotely diagnose or treat wounded soldiers.

In Phoenix, the small devices that VA patients receive include peripherals that let them check everything from oxygen to blood sugar levels. The devices can also ask questions, such as whether a patient has chest pain or shortness of breath that day. A patient answers by pressing buttons on the device. Hospital nurses review the patient-submitted data.

The program has resulted in a significant decrease in hospital and emergency room visits, which saves money, Buckle says.

“Before, we were reactive. Now we provide proactive care,” she says.