Electronic medical records come to Camden

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In a move to improve medical care and cut unnecessary services, Camden's three health systems will begin to go live Monday with a citywide health record that should enable doctors to better know their patients' medical histories.

The Camden Health Information Exchange is one of the most advanced of a small number of efforts nationally that seek to create broader medical-record systems, experts said.

Unless patients opt out during any hospital visit, anyone with a Camden address will be included in the records exchange, making their recent hospital admissions, hospital-based lab and radiology results, medical tests, and discharge reports part of the database.

Stringent safety protections will be included, too. Doctors will need written consent from patients each time they want to access the records.

After a soft launch of the system that begins Monday and is likely to last a few weeks, the medical records in the database will be available when needed by physicians from other health centers.

The exchange is an effort by the Camden Coalition of Healthcare Providers, a city nonprofit group that teamed up with Cooper University Hospital, Lourdes Health System, and Virtua Health.

The shared database is meant to improve hospital care by making it easier for doctors to track patients, especially those with chronic conditions, and reduce costs from repeat tests, said Jeffrey Brenner, the coalition's executive director and a former family-practice physician in Camden.

Brenner said he expected the database would save money by improving care coordination.

A study by the Harvard School of Public Health last year found that eliminating redundant tests would have saved U.S. hospitals $8 billion in 2004 alone. With the new database, the cost savings in Camden "could pretty quickly add up into the millions," Brenner estimated. "Everyone realizes that when we don't share information, the patients suffer."

Staff members from the three hospitals have been meeting with Brenner's team regularly since the spring of 2009. "This is brand new work," Brenner said. "There are [less developed] examples around the country, but it's a steep learning curve."

The collaboration is unusual and much-needed, said physician Richard Baron, chief executive officer of Greenhouse Internists in Mount Airy, who wrote an article last spring for The New England Journal of Medicine on electronic health records.

"In most communities, it's been very difficult to get disparate players in the same room to even talk about what they're beginning to do in Camden," he said. "There's a very strong sense within Camden . . . [that] we really need to do something differently."

In most cities, including Philadelphia, patients can move among different hospitals and emergency departments, and the doctors who treat them may not know their care history. So tests, prescriptions, and other procedures can be duplicated.

Because many Camden residents visit the city's hospitals regularly, Brenner said he expected about half of the city's 79,000 residents will be part of the database within a year.

Each of the three health systems is contributing $50,000 a year to the effort, Brenner said. The Merck Company Foundation is also donating $50,000.

The project's second phase, which could come within 12 months, will add laboratories, radiology providers, primary-care physicians, and other hospitals to the information exchange, Brenner said.

The Camden database is one of four health-information exchange programs in New Jersey receiving funding through the federal stimulus package, according to the state Health Department. The Camden effort will receive about $1 million, while the other projects - in South Jersey's Shore counties, in Newark, and in northern and central New Jersey - will each get $3.5 million.

The Camden database could serve as a model to other cities, said Poonam Alaigh, New Jersey's health commissioner. "It's very important," she said, "especially because if we can learn about improving clinical outcomes in the most vulnerable, then you know you can make an impact when it comes to the larger population."

Alexander Hatala, president of Lourdes Health System, said the Camden exchange "provides a great learning laboratory for what health care will look like under health-care reform," passed in the spring.

"What health-care reform is all about is person-centered care and value-based purchasing."

The health-information exchange will help physicians to track their patients better, especially those who require frequent care and visit many emergency departments, said James Dwyer, Virtua's chief medical officer. Without the system, patient data recorded in each hospital might not reach other physicians, he said.

Patients also may forget to mention the care they've received or a hospital visit they've had, added Emma Brandon, director of clinical information systems at Cooper University Hospital.

The more accurate information available to doctors, she said, the better the patient care.

If the database shows a patient is bouncing from hospital to hospital, Lourdes' Hatala said, that might be a red flag that the person is without a primary-care provider. That knowledge could help hospital caregivers link the patient to a doctor.