Paperless medical records: moving from plan to reality

Area of Science:

• Medical Informatics
• Radiology Workflow Optimization
• Health Information Technology

Background:

• North Shore Magnetic Imaging Center (NSMIC) faced challenges with staff frustration and patient care levels.
• A major restructuring of the patient process was deemed necessary in 2002.
• An aggressive 16-month timeline was set for developing and implementing a paperless environment.

Purpose of the Study:

• To transition NSMIC to a paperless environment.
• To enhance patient care and alleviate staff frustration.
• To integrate new technologies into the existing radiology information system (RIS).

Main Methods:

• Upgraded the existing radiology information system (RIS) with custom programming.
• Implemented a Health-Level 7 (HL7) interface for seamless billing information transfer.
• Introduced wireless personal computer (PC) tablets for technologists to gather patient data efficiently.
• Formed an internal 'Reinvention Team' with diverse personality profiles to manage project impact.
• Addressed technical and patient-related breakdowns in weekly team meetings.

Main Results:

• Successfully developed and implemented a paperless environment within the established timeline.
• Reduced the rate of claustrophobia in patients from 1.9% to 0.99% over 12 months.
• Enhanced patient experience, leading to reduced anxiety during imaging exams.
• Improved staff workflow and efficiency through technology integration.

Conclusions:

• The transition to a paperless environment at NSMIC significantly improved patient experience and reduced claustrophobia rates.
• Customized integration of technology, including RIS upgrades and wireless tablets, was key to success.
• Effective team management and problem-solving were crucial for overcoming implementation challenges.