25 Apr Carl Christensen says Marshfield Clinic's history gives it an IT edge
In the last decade, technology applied to medical records and other information has become hot enough to raise a new term, “medical informatics,” to more common usage. At the Marshfield Clinic, they didn’t wait for that groundswell.
They were old hands by the time medical informatics associations and journals began to emerge. As far back as 1964, the visionary physicians leading the clinic saw technology as one response to the rising tide of information flooding down on practitioners. The clinic’s first system for diagnostic records came up in 1967 and a complete records management module was installed in 1985. Not content with simply moving forward, the clinic loaded paper records as far back as 1960, creating a researcher’s gold mine of electronic medical data.
So why start talking about the current chief information officer by digging up almost 50 years of history? Because it’s the first thing Carl Christensen, CIO of Marshfield Clinic, wants to talk about.
He attributes much of his success and the success of his IT organization to the work of those who have gone before and the culture of technology acceptance that permeates the clinics. Clinic leadership doesn’t just tolerate information technology as a given expense in modern medicine. They actively pursue new ideas about using IT to improve the quality and efficiency of health care delivery.
Recent developments in both technology and industry-wide awareness have made the technology-medicine marriage a little easier for Carl and his staff. For example, the clinics are on the verge of eliminating paper charts. They’ve had an electronic chart system since 1994, but the device technology was just too intrusive at the bed-side until the recent advent of robust wireless networking and tablet computers. Carl’s staff are rolling out 30 tablets a week to physicians, and they hope to be completely off paper charts soon. As a result of these and other efforts, the clinic was named one of the 15 top connected health care facilities in December 2004 by HealthImaging and IT magazine.
Carl says that the electronic charts and tablets represent a kind of wrap-up of a medical records project. Just as most of the industry is really getting into electronic medical records, Carl and his peers have the clinics moving onto the next phase, which is medical decision support.
Lest you get worried about seeing Dr. Computer next time you visit your local clinic, he offers a simple example of how prescription decisions get made. A common drug prescribed for cholesterol costs the same amount regardless of the dose per pill. The prescription system provides this information to doctors at the point where they write the prescription. They don’t have to read a memo on their private time or go to a Web site to find the information and then remember to apply it. They get this information as a natural part of their decision-making process and can prescribe pills with double the dose (but the same cost) which the patients then cut in half to get the same medical result at half the cost.
This little example uses technology to save patients millions of dollars a year.
Making sure the information technology gets used in medically appropriate ways is critical for the clinics, and Carl points to the fact that he has a physician counterpart in charge of medical informatics. Many of the clinic leaders are physicians and physicians are active in the development of new systems as well.
“I often have almost as many physicians as programmers working on development of new clinical systems,” Christensen said. Keeping IT aligned with medical and care objectives has never been a problem at the Marshfield Clinic. This creates an atmosphere in which the technology becomes a natural extension of the physician’s work with patients.
IT does have its challenges at the clinic. As with many CIOs, Carl is faced with dividing limited resources between supporting existing systems and driving all that innovation. Staffing also represents a challenge, finding people who are right for the strong physician/technologist collaborations that are key to the clinic’s IT success.
That said, Carl always returns to the long tradition of positive regard for the potential of technology as a foundation for addressing any challenges. He’s quick to point out the advantages of access to and the attention of the “business” experts, the doctors and staff of the clinics. With that mutual regard, Carl Christensen and the Marshfield Clinics can look forward to many years of productive innovation in medicine and information technology.
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