The area’s largest health care providers are ramping up their electronic medical records and data mining systems in a race to get smarter and healthier faster.

Health care initiatives, including $27 billion in incentives from the federal government to implement the latest technology, are rolling out to lower costs and improve health outcomes. Those who do not invest could face penalties beginning in 2015.

New Hanover Regional Medical Center (NHRMC) and three Brunswick Novant physician groups so far have adopted new electronic medical records systems that enables doctors to access patients’ medical history, medications and current treatments at any time. That means a new specialist or an emergency room physician can instantly access your medical record while treating you.

While NHRMC and Brunswick Novant are investing millions of dollars in new electronic medical records systems, one of the largest physician groups in the area is taking it to the next level. Wilmington Health went live this spring with a new system that mines data from its electronic medical records to see which patients are most at-risk, which doctors are having the best results and who stands to improve patient health outcomes.

“The assumption in medicine for a long time is that if every doctor does a good job, the population will benefit, but that’s not necessarily true,” said Dr. Sam Spicer, vice president
of NHRMC’s medical affairs.

Wilmington Health’s new software can group patients’ health records by disease state or physician so it can look at its patient population as a whole.

“First, you have to identify your populations. Then you have to measure how well you’re doing,” said Dr. Jonathan Hines, Wilmington Health’s chief medical officer. “But until you can measure it, there’s no discussion to be had.”

The new system created by Boston-based clinical analytics company Humedica gathers data from Wilmington Health’s Allscripts electronic medical records system.

“In southeastern North Carolina, we’re the only provider group that’s looking at working on improving certain segments of the population: diabetes first then pediatric asthma, congestive heart failure and a number of other ones. Those disease states are some of the highest cost drivers of the health care system,” said Jeff James, Wilmington Health CEO.

About 12.4 percent of adults have been diagnosed with diabetes, according to the New Hanover County Health department.

“We are actively pursuing the diabetic population. We do believe we can tangibly improve the health of that population in a relatively short period of time,” James said.

How they will do that is by implementing best practices and changing protocols.

“It will force our group and all physicians to say, ‘Maybe there are better systematic approaches to taking care of patients, because what we’re doing now is probably not as good as we think,’” Hines said.

Wilmington Health has joined a collaborative of 18 clinics, including the Mayo Clinic that meets twice a year to critically examine their data and share best practices. Since launching the Humedica MinedShare system in May, Wilmington Health has met with the Anceta Collaborative once and will meet again in October.

Crystal ball

The new system also identifies patients who are most prone to congestive heart failure, one of the costliest disease states because of its high rehospitalization rate. Blood test results, weight, medications and previous heart conditions are a few of the 15-20 components that identify someone at-risk of congestive heart failure. The goal is to get to those patients before they need to be rushed to the emergency room.

“We estimate that we have on the order of 300 high-risk patients. And if you saved five rehospitalizations because you were more attuned to these issues, you could be saving $100,000 a year, easily,” Hines said.

Wilmington Health plans to hire more staff to roll out this intervention outreach program, James said.

The data mining has also revealed that 85 percent of Wilmington Health’s eligible female patients receive mammograms.

“If we can move mammograms up to 90 percent, certainly we will improve our quality, but that number is going to save lives ... And isn’t that what we are doing? That is the part we cannot lose sight of,” James said.

Coordinated care

Even without the detailed data scrutiny, other area health care providers are turning to technology.

NHRMC invested $56 million in a new electronic medical records system it recently rolled out. It coordinates about 300,000 patients’ diagnoses and treatment history, said Dr. Tad Dunn, NHRMC’s chief medical information officer.

Until now, fax machines were the main tool physician offices and hospitals relied on to share patients’ medical history, NHRMC’s Spicer said.

The hospital contracted Wisconsin- based vendor Epic Systems for its hardware, software and training. The training of 550 NHRMC physicians and 250 mid-level providers cost the most, Spicer said. But NHRMC could recoup up to 25 percent of the cost of the project through defrayed expenses from federal incentives.

Also, three Brunswick Novant physician groups have hired Epic for their new system. Winston-Salem-based Novant Health, which owns the hospital in Brunswick County, is investing $700 million systemwide to convert all of its physician groups – numbering in the hundreds – to Epic. Brunswick Novant Medical Center plans to convert to Epic as well.

Some of the state’s largest hospitals including Duke University Health System and Wake Forest Baptist Medical Center use Epic for their records. Once Novant converts, about 70 percent of North Carolina’s health records will be on Epic, Dunn said.

About 250,000 physicians use Epic nationwide, accounting for 35-45 percent of Americans, he said.

CUTLINES/COVER:
New Hanover County’s Health

Leading cause of death: Heart disease

64.8 % of adults are obese or overweight

5.5 % of adults have been hospitalized due to diabetes

6 % of adults have had a heart attack

Cancer is the second leading cause of death

Higher death rate among African American men from cancer, unintentional injuries and homicide

80.6 % don’t eat a properly balanced diet

Source: New Hanover County Community Health Assessment 2011