Farm Workers Clinic uses latest technology to better serve its patients


Dr. James Gaensbauer and Nursing Assistant Sonia Cardenas use the IC-Chart electronic medical records system to check on a patient's information. The new system being used by the Yakima Valley Farm Workers Clinic puts all of their patients' medical information into one central location.

A young mother walks into the Yakima Valley Farm Workers Family Medical Center in Walla Walla, carrying her sick child, looking for nothing more than something to cure the ailment that has suddenly overcome her feverish son. Not speaking the language and living in the Lower Yakima Valley, the only reason she's in Walla Walla is because she's followed the harvest.

She sits in the exam room, watching the doctor carefully note her little boy's vital signs. When asked if the boy has any allergies to certain medications the mother pauses, unsure what was asked of her and simply shakes her head, no. What she didn't tell the doctor is that her son is highly allergic to the antibiotic the doctor is just about to prescribe to the ailing child.

It's situations like this that staff at the Yakima Valley Farm Workers Clinic are hoping to avoid as they implement some of the latest technology in the medical field. The center is in the middle of a five-phase plan to implement the use of an electronic medical record system.

Diane Tschauner, information services director for the Yakima Valley Farm Workers Clinic, explained that the system will make it possible for all doctors in the 15-clinic organization to view a patient's medical record at the touch of a button. She explained that using the system being implemented by the organization, all of the information being collected by all of the doctors at the various clinics is dumped into one central location, where it can be accessed by those who need to see it.

Tschauner said although all of the clinics in the Farm Workers system are beginning to use the new technology, the pilot site is the Walla Walla facility. She noted that the site was chosen because the staff there was really supportive of the effort and were excited about trying the new technology.

"We got it rolling there, then broke out to other clinics," Tschauner said.

According to Tschauner, the program being used by the Farm Workers Clinic, IC-Chart by InteGreat, was first put into use in Walla Walla in April 2004. She noted that since then all of the clinics have started implementing the new electronic medical record system. She added that it will take two to three years to fully implement the system in all of the organization's clinics.

Tschauner explained that the first phase of the implementation process has included using the new system to take care of basic clinical work flow. Soon it will be used to fill prescriptions.

She noted that basic clinical work flow means that doctors' schedules are being set up using the system and medical charts of patients are starting to be switched into electronic form. Tschauner said at this point many doctors are using a combination of both paper and electronic charts when they visit with a patient. She said one day soon, doctors will make the switch to relying completely on the electronic medical records.

"It gives them different tools, but they're doing the same work," explained Jim Simmons, electronic medical records project leader.

He explained that IC-Chart is designed to bring information doctors input about their patients into the medical records system. Once in the system it is put into the patients' central file, where the data can be viewed by those health officials who need access to it, whether the patient is in Grandview, Toppenish or Yakima.

"They can review everyone from one location," Simmons said. He explained that doctors will have one medical record to view for a patient, instead of a patient having one chart in Yakima and another in Grandview, depending on where they are receiving medical attention.

Simmons said at this point the Farm Workers Clinic is about to begin implementing the third stage of phase one, which will allow medical personnel to start prescribing medications electronically.

Tschauner noted that the work the Farm Workers Clinic is doing is relatively new to the state. She said the technology is something that is just starting to be seen in Washington. She added that one of the main reasons the Farm Workers Clinic decided it was time to make the transition is because it's something that its doctors wanted. She said many doctors are coming out of their residencies having used similar systems. Tschauner said many of them are no strangers to the technology, meaning they are eager to implement the system in their everyday practices.

Tschauner said the second phase of the implementation process should phase out the use of paper charts in the clinics, while phase three will make it possible for physicians to use the system to order lab tests. She said phase four will allow doctors to store their dictations in the electronic medical records. The final phase, according to Tschauner, will be to store x-rays in the system, as well.

In the scenario of the mother unable to communicate with the Walla Walla doctor, thanks to the new electronic record system, when the physician tries to prescribe an antibiotic for the boy he's notified immediately through the new system about the young boy's allergy to antibiotics. And that, say Farm Workers staff, is what the new medical record system is all about.


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