I have posted notes in the past about Cerner's Winona Health Project (see: The Winona Project: Is This a RHIO Success Story?). The project received very laudatory coverage on the PBS New Hour last night (see: PBS News Hour to feature Winona's Health Information Technology). Cerner is certainly to be commended for having launched this community-wide demonstration project five year ago and sticking with it over the years to achieve a successful result. The town, hospital, and medical practitioners were hand-picked because of their willingness to serve as a guinea pig for this experiment, but this detracts little from the successful outcome that can be seen today. It's a pity that more communities have not emulated the electronic medical record success experienced in this small Minnesota town.
Four points from the News Hour piece jumped out at me as very interesting and worth repeating, so I now present them to you:
- The CEO of Winona Health, the town's 100-bed hospital, is quoted as saying that there were only three PCs in the entire facility five years ago when the project was launched. She cites this as evidence about how much progress in computer literacy has been achieved in a relatively short time.
- The statement is made during the program that much of the emphasis of the project since its inception has been on personal health records (PHRs). I believe that this is a bit of a misstatement. The concept of the PHR hardly existed when the project was initiated five years ago. My recollection is that there was the expectation that patients would have the opportunity to input some of their personal health information into the electronic medical record and review such records from home. What we now understand as web-based applications and the PHR did not exist when the project was launched.
- The point is made in passing, and worth emphasizing, that the Cerner system installed throughout the entire town lacks interoperability with the EMR system running at the neighboring Mayo Clinic. When residents of the town are admitted to that health system, their comprehensive electronic records can't be viewed.
- Germane to this last point and also of great interest was the statement by one of the physicians that most patients in Winona have little interest in generating data for inclusion in their PHRs or even accessing their health records on-line. According to him, only about 10% of patients in Winona bother to use the system. Recall that this lack of interest occurs under very optimal conditions with access to a wide array of data. According to him, patients take a greater interest in accessing health information replicated to their PHRs from the hospital and physician office EMRs. This is sometime referred to as a "tethered" PHR system. I have made this same point in a number of my previous notes about PHRs.
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