Published Wednesday
June 8, 2005

Digital patient records catch on

BY JULIE ANDERSON

WORLD-HERALD STAFF WRITER

It started when transplant patients' records began filling file cabinets and the file cabinets began filling rooms.

Dr. Byers "Bud" Shaw Jr.

Dr. Byers "Bud" Shaw Jr., then a liver transplant surgeon, now the Nebraska Medical Center's chief of surgery, went to work on a computer database system to corral the paperwork.

That system - the Organ Transplant Tracking Record, or OTTR for short - now is in place in 158 transplant programs at 44 hospital sites in three countries.

And HKS Medical Information Systems Inc., the Omaha company Shaw founded 12 years ago with Paul Kenyon and Hubert Hickman, is on the leading edge of computerizing patient records.

HKS, which employs 22 people, was named one of the 500 fastest-growing private companies in 2003 by Inc. Magazine and recently received the Walter Scott Entrepreneurial Business Award from the University of Nebraska.

The company's aims, however, go beyond organizing charts. It sharessome of the national goals of creating electronic health records, including improving patient care and cutting costs.

"The Holy Grail is, 'How can it cut health care costs?'" said Doug Perry, president and chief executive officer of HKS.

Perry cited a recent study indicating that administrative costs accounted for 31 percent of health care spending in the United States.

Perry said he was struck by the amount of health care dollars going to administration. As a small-business owner who went through surgery last year, he said, he is conscious of the high cost of health care.

"I think a better application of information technology is part of the solution," he said.

Electronic systems also may help health care providers recoup more revenue, Perry said.

President Bush has set a goal that most Americans have electronic health records within 10 years. Some Nebraska officials believe the state could have a network to share such records before then.

Two other local companies also are moving ahead with electronic health records.

MediGrafix Inc. plans to switch over June 1 to a new electronic health record system that will update patients' files via the Internet within 12 hours of an office visit. The Omaha firm provides medical transcription services to about 75 percent of hospitals and clinics in the metropolitan area.

HDC 4Point Dynamics is planning to launch a secure Web site July 1 where patients can update their personal health records. Doctors also could feed information into the records.

Patients could use the company's existing memory chip-embedded "smart card" to take basic information with them for scanning in an ambulance, at a hospital admissions desk or in a doctor's office.

Meanwhile, HKS is expanding its transplant record system for use in more hospital programs. Mount Sinai Hospital in New York City is testing the system for use in bone marrow transplants.

HKS further broadened its offerings last year when it began distributing a separate electronic medical record and practice management system for doctors in private practice or clinics.

That system, SmartMedix, covers everything from scheduling patient appointments to charting their visits.

The system was created by a North Carolina firm that, like HKS, was founded by physicians and information technology experts. So far, HKS has installed SmartMedix in two doctors' offices - one in Papillion and another in Hastings.

As of 2003, electronic medical records systems were in use in slightly more than 17 percent of doctors' offices, according to the federal Centers for Disease Control and Prevention.

Nearly one-third of emergency and outpatient hospital settings used them in 2001-02.

The transplant tracking system, however, is more complex than most patients are likely to need, HKS' Perry said.

"This is the Mack truck when just about every other patient (record) is a Volkswagen," he said.

That's because transplant programs continue to follow patients through the rest of their lives, monitoring everything from a bout of pneumonia to a change in medication.

The transplant system includes a database with about 4,500 data fields. It provides pop-up reminders for tests and checkups and talks to other systems within the hospital so that lab tests and other information get added to patient record.

"It takes the people that are using it a while to get used to it," Perry said. "But once they get it built into their daily routines, it does save a considerable amount of time, and it will improve accuracy."

An analysis by St. Barnabas Medical Center in Livingston, N.J., noted that the system decreased administrative time for its transplant division, increased data accuracy and availability, and decreased costs. Even patients' average stay was shorter.

"We think our software can be looked at as a revenue tool," Perry said.

About HKS Medical Information Systems

HKS Medical Information Systems, Inc. is a private company headquartered in Omaha , Nebraska . Founded in 1993 by Dr. Byers Shaw of the University of Nebraska Medical Center, Hubert Hickman and Paul Kenyon Ph.D., HKS products improve the quality of patient care and operational efficiencies for its clients. Products include OTTR, the market leader in patient tracking software for organ transplant centers and OTTR-HLA, which is a comprehensive software system to support the patient management, reporting and regulatory needs of the HLA laboratory.