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The Appalachian Region
Reducing health disparities will require a
multifaceted approach, focusing on health care
workforce recruitment, infrastructure
development, and improved access to care.
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Organizational Structure
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OhiONE Telehealth Network
13 Academic Hospitals 5 OUCOM Sites 4 OU
Regional Campuses 11 Southern Consortium for
Children Sites 10 ODMH Sites
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Regional Issues

• Declining state and federal funding
• Isolation of medical information
• Isolation between institutions
• Isolation between disciplines
• Socioeconomic profile
• Difficulty in recruiting and retaining primary
  care physicians

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Healthcare Management Issues

• Immunization- access to documentation
• Lack of access to information for research
• Rising cost
• Medical Records
• Insurance and risk management
• Human Resources
• General Operating Costs
• Medical errors

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• Appalachian Regional Informatics
• Consortium
• Next Generation Grant (NGG)
• Integrated Advanced Information Management
  Systems Program (IAIMS)
• National Library of Medicine (NLM)
• National Institute of Health (NIH)
• Department of Health and Human Services (DHHS)

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Mission Statement

• To create a sustainable and replicable model for
  integrated advanced information management
  systems for rural healthcare in Appalachian Ohio.
  

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Building a Model (mission statement cont.)

• The model will establish a formal organizational
  structure and a comprehensive technical plan for
  a shared medical information system to benefit
  primary and behavioral healthcare providers,
  biomedical researchers and medical educators.

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Partners

• -Alcohol, Drug Addiction and Mental Health
  Services
• -317 Board of Athens, Hocking and Vinton Counties
  and the Southern Consortium for Children
• -Appalachian Behavioral Healthcare Center
• -Doctors Hospital of Nelsonville
• -Health Recovery Services
• -OBleness Memorial Hospital
• -Tri-County Mental Health
• -Ohio University
• College of Osteopathic Medicine
• College of Health Human Services
• Edison Biotechnology Institute

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Three County Profile

• Three counties were selected as the sample area
  for this project.

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Why an Electronic Medical Record? (EMR)

• Paper records have at least 4 weaknesses
• Lack of standardization in content
• Lack of standardization in format
• Incompleteness
• Inaccuracies
• Source Committee on Improving the Patient
  Record,
• Institute of Medicine

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Process vs. Practice

• Physicians spend up to 38 of their time writing
  up patient charts.
• Nurses spend up to 50 of their time writing up
  charts.
• Medical records are misplaced or missing in 30
  of patient visits.
• The average patient record weighs 1.5 lbs.
• Source Committee on Improving the Patient
  Record,
• Institute of Medicine

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Cost and Quality Benefits

• A quality-assurance staff can review 3 paper
  records per hour.
• Based on predetermined data-base criteria, a
  quality-assurance staff can review 400 electronic
  medical records per hour.
• The average patient visit generates 13 pieces of
  paper.
• The average office spends 10 per visit to track
  and file paper records.
• Source Committee on Improving the Patient
  Record,
• Institute of Medicine

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Patient Care Errors

• A patients age is not included in the medical
  record 10 of the time.
• A diagnosis is not recorded in the patients
  record 40 of the time.
• Physicians, while taking a medical history, fail
  to note the chief complaint in the patients
  record 27 of the time.
• Source Committee on Improving the Patient
  Record,
• Institute of Medicine

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Questions ?