NC Doctors Move Peers Toward Health IT

Getting Technical with Dr. John Torontow

When Dr. John Torontow began practicing medicine, he was one of the first physicians who found it helpful to use a handheld device to record patient notes. As an early adopter of health information technology (health IT), Dr. Torontow has always turned to new technologies to help him find efficiencies and re-imagine the way he practices medicine. Now that he is using electronic health records (EHR), Dr. Torontow is beginning to see health IT help his patients, too.

Dr. Torontow is a practicing physician at Piedmont Health, a federally qualified community health center in North Carolina. Piedmont has employed an EHR system for the past three years, eliminating paper charts in favor of a computerized system linking records from nearly 50 providers.

Benefits of Health Information Technology

Health IT and EHRs offer several benefits for patients and providers by providing accurate and complete information about an individual’s health, including comprehensive medical history, lists of prescribed medications and test results, all ready at the physician’s fingertips. Nationwide EHR adoption is part of a Recovery Act-funded federal initiative to help make the health care system more efficient and improve the quality of care. As patients visit Piedmont’s seven locations, their records remain up to date and secure no matter which physician they see. But sometimes, the patients who don’t see a provider when they should are most in need of care.

How Health IT Is Working to Improve Care in North Carolina

“The number one thing is that we now know who we’re not seeing, as well as who we are seeing,” Dr. Torontow said. “With EHRs, we can look in our system and tell people to come back for follow-up appointments. Before, with paper charts, there was no way of knowing who had high blood pressure and needs to be followed up with, or who has poorly controlled diabetes.”

With their EHR system, Dr. Torontow and his fellow providers now know exactly how many of their patients have risk factors for serious diseases. Piedmont has established a standard procedure for helping these patients. The Piedmont lab director runs regular reports on risk factors, pulling data from the EHR system. The reports are sent to providers, who work with care managers to call each at-risk patient to encourage them to come back to the center for follow-up tests or other care.

Patients have responded to the increased, targeted communication, and are more likely to return for treatment. According to Dr. Torontow, since the process began in 2008, Piedmont has had a 10 to 15 percent reduction in the number of patients with high (greater than 9) hemoglobin A1c levels — a diabetic indicator. By better managing chronic diseases like diabetes, Piedmont helps its patients avoid escalating problems due to fluctuating blood sugar levels. This keeps patients healthier, and reduces their need for often costly care.

Leading the Way

Piedmont is a leader in health information technology, and its providers plan to become “meaningful users” of EHRs in early 2011, making them eligible to receive federal EHR adoption incentive payments. Piedmont’s Dr. Torontow is also one of a growing number of early adopter providers nationwide identified by the U.S. Department of Health and Human Services’ Office of the National Coordinator of Health IT as a participant in the Meaningful Use Vanguard (MUV) program. Dr. Torontow is a leader in EHR adoption and meaningful use achievement who serves as a champion and adviser to other physicians as well as his local Regional Extension Center (REC), the North Carolina Area Health Education Centers program (AHEC).

Not all providers are as quick to adopt new technologies into their practice as Dr. Torontow, so his work as a “MUVer” will help “move” his peers toward EHRs and act as a resource on how to use health IT.

Resources for Health IT Adopters

MUVers work closely with their local RECs, which offer technical assistance aimed at helping health care providers become meaningful users of EHRs. Sixty-two RECs nationwide received $677 million in Recovery Act-funded grants, and are identifying MUVers like Dr. Torontow in communities across the country to link them with other providers to encourage EHR adoption and provide help on such technical issues as selecting EHR vendors.

AHEC has identified over 80 MUVers in the state who are already working with health IT to achieve improved patient outcomes and quality of their care. The North Carolina REC holds quarterly regional collaborative meetings at which these MUVers can share their best practices and discuss how to improve care by using EHRs to help treat asthma, diabetes and other chronic illnesses.

“The collaborative allows doctors to get together and share,” said Dr. Sam Cykert, clinical director of the North Carolina REC. “Meetings are kind of a show-and-tell. MUVers tell how they did an outstanding job, usually working as a team to identify needs in the practice. They also highlight things that didn’t work, and talk about lessons learned. This perspective is brand new, and fresh.”

Physicians and their support staff attend these meetings together to include every member of the office involved in the patient care process. MUVer providers have already analyzed how to integrate new systems into their practices, and have changed their practice workflow and organization to use these electronic systems in a way that most benefits the care of their patients and makes the business part of their practices more efficient. MUVers help the new health IT converts understand how to make EHR adoption easier for everyone in a practice, from doctors to appointment schedulers.

RECs are providing the infrastructure and organization for this collaboration, and Cykert anticipates that MUVers will play a key role in helping his REC test new innovations that will impact health outcomes in the future.

Summary

“Health IT itself isn’t the endpoint. It’s the outcomes that count,” Cykert said. “It takes all people — including champions like Dr. Torontow and later enthusiasts who follow his lead — to get to the great outcomes that we can only get to using what health IT can do. This requires an extremely coordinated effort through local leaders and the type of services that RECs can provide.”

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