February 2002 Bulletin

Connecting to your hospital computers

Electronic coordination improves efficiency, patient care

By Ronald Sterling, CPA, MBA

Hospitals are constantly searching for ways to improve and manage their relationships with orthopaedic practices. One of the most efficient strategies for accomplishing that is through the exchange of electronic information. These information exchanges can take many forms and include the hospital giving you access to patient information contained in their computer databases. In other instances, you will be allowed to schedule procedures, enter information into their systems, and otherwise communicate directly with the hospital. Depending on the speed of the connection to the hospital computer system, you could even access diagnostic images, EKG readings and other images through the same connection.

Anything that helps your practice coordinate electronically with the hospital makes better use of your resources and improves patient care. These services can give you a competitive advantage by eliminating the coordination hassles for patients and improving your ability to track patients served by that hospital. From the hospital’s perspective, these added value benefits will improve service by allowing you to more effectively manage and track patients admitted to their hospital when compared to other hospitals. The basic connectivity strategies include:

Terminal Access—Some hospitals will provide physicians with in-office terminals to directly access their computer systems. In fact, there are many practices that have a line of terminals set up in their offices—one for each hospital where the surgeons have privileges. In most cases, the hospital incurs the costs of these connections.

If you want to reference information on a patient, you can go to the specific terminal for that hospital and access the appropriate information. This capability makes access easier for you and simplifies operations in the hospital. Unfortunately, most of these connections are limited to text information and do not allow you to save the data in your own computer; your only option to maintain the information in your system may be to print out the document and file the paper copy in the patient’s medical record.

Internet Access—Internet access to hospital information is more efficient for practices since you can use the same equipment and connection to access the information from several hospitals as well as that for insurers, labs, and others that are using the Internet. Additionally, you can set up a connection that would allow users from any workstation in your practice to access hospital-based information on your patients as well as manage future admissions over the Internet.

Ultimately, all hospitals will offer data through the Internet. Indeed, hospitals will eventually offer patients access to their records, patient service and marketing materials over the Internet. However, in many cases, the practice must incur the cost of the equipment and connections. Several Internet connection strategies allow you to capture and save information on your practice management or medical record systems.

Connectivity with your Practice Computers—In some cases, you can directly access or download information from the hospital system through your existing software. These downloads may be done in a group (e.g., all patients in the hospital for the practice) or be based on a specific query (e.g., post-op status for a patient). Such exchanges may be supported through a direct communication link with the hospital, or the Internet. You will have to get your software vendor to write a program to exchange information with the hospital. Such programs start at $5,000 for each type of interface (e.g.) demographics, lab reports) for each hospital. This strategy is only practical for hospitals that you do a lot of business with and whose systems support such exchanges.

Electronic relationships to grow—These electronic relationships will become more significant with the upcoming Health Insurance Portability and Accountability Act of 1996 (HIPPA) transactions and the expanding use of electronic medical records (EMRs). As practices build computer infrastructures to support EMRs, they will demand seamless electronic interactions with their business partners (e.g., other practices, hospitals and insurers) to capitalize on their computer investments and improve patient services. If such relationships remain paper-based, then practices and hospitals will have difficulty using computers to improve services and control costs.

By enabling electronic exchanges with the hospitals you work with, your practice will be able to more effectively manage patient paperwork and improve the efficiency of your physicians and staff. The current connectivity strategies with hospitals will ultimately determine the benefits your practice and your patients will derive from your investment and use of technology.

Ronald Sterling, CPA, MBA, of Sterling Solutions, Silver Spring, Md. is a nationally recognized expert on electronic medical record and practice management systems. (rbsterling@aol.com)

Computer Link welcomes suggestions about future topics for the column and questions about the use of computers in orthopaedic practice. Send your suggestions to the Bulletin at AAOS, 6300 N. River Rd., Rosemont, Ill. 60018.

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