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BCM WiredTechnological advances enable College's transition to digital ageby Ross Tomlin Someday soon, a digital cornucopia of your medical history will be accessed instantaneously with just a few clicks of the mouse. Everything from your medication history to up-to-the-minute alerts on new research about your conditions will be available online for your personal physicians to see. Welcome to the wild, wired world of medicine. Ready or not, the emergence of shared electronic medical records (EMR) and other automated, network-based tools represents a revolution that patients and medical institutions like BCM desperately need. Rest assured that your health information will remain tightly protected from those you have not authorized. "New technologies have the potential to transform healthcare in a way we can hardly imagine," said Dr. John Joe, assistant professor of family and community medicine at BCM. While 15 percent of physicians in the United States already use EMR, many physicians, particularly those with decades' worth of patient records, are reluctant to make the switch. However, more and more patient exam rooms, like those at Baylor Clinic, are getting equipped with computers and flat screens that swivel back and forth between doctors and patients, permitting more interaction, greater communication, and, as studies show, better outcomes. Streamlining health information in this way results in speedier check-ups, an expanded knowledge base, and reduced health costs. The Future Is HereActing on its first strategic imperative to "Deliver Tomorrow's Medicine Today," the college recently signed a $4 million, multi-year contract with Clinical Content Consultants to tailor-program the EMR system specifically to the needs of those departments at Baylor Clinic. Doing so will customize data-gathering protocol for subspecialties and ensure that doctors' workflow is carried out more efficiently. Eventually, patient requests for test results and prescription refills will be made securely over the Internet while services like appointment reminders will be automated, freeing the clinic's support staff to do other things, says Baylor Clinic Medical Director Dr. Jeffrey Steinbauer. Some clinics, including those for BCM's OB/Gyn and Family and Community Medicine, already allow patients to enter health information about themselves at computerized kiosks in waiting areas. Electronic record-keeping is also used regularly by the Breast Center, the pediatrics department, and the endocrinology and pulmonary sections in the department of medicine. Aside from EMR, the college plans to implement forms of telemedicine that enable patients with chronic disease—such as diabetes, asthma, or congestive heart failure—to submit their vital signs and other daily test readings from home over the Internet. Monitoring patients remotely has so far proven effective at improving patient compliance and reducing hospitalization needs. High-tech health services like electronic surveillance were a common trait among US News & World Report's 2005 "100 Most Wired" hospitals in the country, a list that includes the Texas Heart Institute at St. Luke's Episcopal Hospital, BCM's primary private adult hospital affiliate. So critical is the need to streamline the accessibility of health information that "The Wired for Health Care Quality Act" achieved the rare feat of bridging bipartisan support. In July, co-authors Senators Bill Frist (R-TN), Hillary Rodham Clinton (D-NY), Mike Enzi (R-WY), and Ted Kennedy (D-MA) introduced legislation to support the creation of standardized, interoperable health information technology between medical institutions. No One Is ImmuneOf course, cutting-edge technology isn't confined to patient care. Medical and graduate students at BCM have access to all kinds of gadgets and online aids. Personal desktop assistants (PDAs, like Palm Pilots™) are required and in some instances issued through the college, enabling students to download handy software apps like ePocrates RX (a free, regularly updated drug reference program) and EBM calculator (which tabulates statistics for diagnostic tests, studies, and trials). One day, PDAs might even function as extensions of EMR, permitting pocket-sized, wireless access to patient records. Online resources such as Baylor Educational Communication Online Network (BECON) post class syllabi online, link to chat rooms, and archive sample test questions. Students can even watch video streams of lectures in the comfort of their own homes. "We have students who are much more used to doing things online with technology than any of us were, so it has taken quite a learning process to get the faculty in line with where the students are," said Dr. Rebecca Kirkland, senior associate dean of medical education. Medical residents are making more use of wired means of communication, an auspicious trend given their wide dispersement across the medical center. Bulletins about ever-changing guidelines regarding patient confidentiality laws and occupational safety hazards, for instance, are difficult to disseminate otherwise. "How do we get information to all our residents?" said Kirkland. "The most efficient way is to do it online." The Research RamificationsPrior to the inception of Baylor's online Biomedical Research and Assurance Information Network (BRAIN) system in 2001, the Office of Research (OOR) faced the tall task of vetting thousands of faculty members' clinical trial applications by shuffling paperwork between research analysts, department heads, internal review board (IRB) committees, and funding agencies. BRAIN greatly simplifies protocol entry for investigators, prompting them to submit information about their human or animal studies' background, sample size, design procedures, costs, and consent forms according to federal regulations. It includes an automatic review for completeness and systematically routes each submission to the appropriate officers for their signatures. Each research analyst can process 35 to 60 new protocols per month with a turnaround of seven to 21 days, shaving oodles of time off of what often took months to complete. As a result, BCM produces roughly the same amount of research as the largest top 10 research institutes of the country—with half the oversight staff. BRAIN is constantly being revised as the college grows and new regulations arise. Meanwhile, a clinical trials management software system called Study Manager is in the initial phases of implementation to help investigators manage their study budget, protocol, and recruitment. Because it is web-based, investigators can keep tabs on their studies from anywhere in the world. "As this gets used by more and more investigators, we will have a much better idea of how large the clinical research enterprise is at the college, which we don't know right now because all of the investigators use their own systems," said Helen Shepherd, director of research infrastructure programs in OOR. "It is very hard to pull together the full breadth of the activities going on here, so this is a significant investment that the college has made to clinical research." But with its confluence of technological advancements in patient care, education, and research, Baylor Clinic is perhaps most emblematic of the college's migration toward more wired ways of advancing medicine. Its online patient registry pre-enrolls potential volunteers for future clinical trial studies before they are even conceived—evidence that the clinic is quite literally ahead of its time. While the modern physician and medical educator may use near sci-fi methods, their motives are timeless. At the heart of this Brave New World of electronic heath care is the old-fashion notion of providing compassionate health care in the most efficient and effective way possible. Time to get plugged in. |
Patient CareResearchThe Next Step in Cancer Research EducationHalf a Century Later... They're Still Giving Back Community ServiceFrom Despair to Hope: BCM Responds to Katrina Alumni & DevelopmentThe Vietnamese Cowboy and the Race Car Driver A Fortunate Life... A Fight Against Cancer College NewsA New Door for the East Campus New Museum to Showcase Maestro of Medicine
Baylor College of Medicine: Making a Difference in the Community
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Volume 1, Issue 3, Fall 2005 |
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| Last modified: December 12, 2005 |