Connections Your source for health and wellness news from Berger Health System.
Special Technology Issue: Advances
in Community Health Care
of Electronic Medical Records Page 6
Safe and Secure: Inside the Patient Portal Page 8
Care first. Community always. Spring 2012
From the CEO Dear Friends, These days, few of us leave the house without some sort of mobile technological device, whether it’s a smartphone to keep track of our families, a tablet to assist us with our job responsibilities, or an iPod to carry along for an afternoon walk or jog. Technology is an ever-present and ever-evolving force in our lives, and it’s made us more connected than ever before. The staff members at Berger Health System are particularly enthused about the new technology we have to offer, which is why it is the focus of this issue of Connections. When considering any investment the hospital makes in new technology, the immediate question I always ask is, “How will this help patients?” I’m not impressed by bells and whistles that add no value, and I know the members of the community aren’t, either. But I’m confident that after you read this issue and learn about our latest advances and initiatives, you’ll see the benefits of becoming an active partner in your own health with your primary care physician through the technology we now provide. On page 3, you can read about our implementation of TeleStroke through a partnership with OhioHealth. TeleStroke technology allows for a two-way, audio/ visual conference between a neurologist and a patient with stroke symptoms. This timesaving technology allows the physician to remotely perform a full neurological exam with the patient in real time to assess symptoms, evaluate appropriate treatment and decide whether a transfer is necessary.
TECH Classes at Berger Berger Health System’s tech team will host two informational classes to help get you comfortable with the latest medical technology advancements right here at Berger. The team will demonstrate and answer questions about topics such as EMR (electronic medical records), QR codes (Quick Response) and more. Class space is limited, so reserve your seat soon. June 15: noon–1 p.m. June 26: 5–6 p.m. Register today by calling 740.420.8222.
Tim A. Colburn President and CEO
Berger has also made significant advances with our computerized physician order entry (CPOE) system, our latest move toward an easily accessible, fully digital records database for our physicians. I can’t help but beam with pride at our nurses who are now part of our IT team and guiding our CPOE system. You can read about the system and team beginning on page 6.
In addition to our staff taking the initiative to become tech-savvy, patients can now assume more active roles in their care thanks to Berger’s adoption of the patientcentered medical home (page 5), our new, secure, online patient portal (page 8), and our enhanced pharmacy program (page 4). We realize that your quality of health care stems from a quality relationship with your physician, and we are pleased to have the ability to inform the community about the many options Berger has implemented to help these partnerships grow.
We encourage you to take advantage of our new, technology-focused classes, which we hope will assist the community by providing education about Berger’s most recent technological advances. Thank you for allowing us to serve you, and remember: Stay connected to your friends, your loved ones, and your health.
Connections is published as a service of Berger Health System, 600 North Pickaway Street, Circleville, Ohio, 43113. All rights reserved. The contents of this publication may not be reproduced in whole or in part without written permission from the publisher. For more information about topics discussed in this publication, call 740.420.8197. This publication in no way seeks to diagnose or treat illness or to replace professional medical care.
tim a. colburn president and ceo, berger health system
Vice President Marketing Strategy/CHRO
Kyleen Valone Marketing/Communication Coordinator
Shea McMahon Social Media/Strategic Messaging Specialist Project & Research Market Manager
Bryan Barr Photography
True North Custom Media Developed By
in Stroke Diagnostics For stroke patients, time is critical. A few minutes can mean the difference between a full recovery and permanent neurological damage.
hanks to a new partnership between Berger Health System and OhioHealth, Pickaway County residents will receive world-class care at Berger Hospital from neurologists specializing in stroke care. The OhioHealth Stroke Network is a video and audio system connecting Berger’s award-winning emergency department (ED) to OhioHealth neurologists at Riverside Methodist Hospital and Grant Medical Center. This TeleStroke partnership allows Berger’s ED staff to diagnose strokes quickly and accurately, helping the patient on his or her road to recovery.
neurological damage. In these situations, Berger and OhioHealth work together to provide a seamless transition of care to the tertiary center. “Berger’s partnership with OhioHealth on the Stroke Network will enhance care for stroke patients in Pickaway County,” said Berger President and CEO Tim A. Colburn. “By taking advantage of the best technology available, we provide vital neurology services at a world-class level right here in Circleville.”
Through its partnership with the OhioHealth Stroke Network, Berger offers patients faster diagnoses, more efficient treatment and increased chances of improved outcomes when minutes matter most. For more information about Berger Health System’s partnership with the OhioHealth Stroke Network, visit www.bergerhealth.com.
Through the specialized technology, these neurologists can guide Berger’s clinical staff through the patient’s exam— viewing CT scans, speaking with family members and even viewing the patient’s pupils through the equipment’s finely tuned cameras. Once a patient is examined, the OhioHealth Stroke Network neurologists and Berger’s physicians collaborate to develop and execute an individualized treatment plan. “The earlier a stroke patient receives treatment, the better,” said Brett Call, D.O., director of Berger Health System’s ED. “With access to the OhioHealth Stroke Network, we can identify strokes quickly and confidently and deliver the best possible treatment for the patient.” In some cases, the patient may need specialized interventional procedures at Riverside Methodist Hospital or Grant Medical Center to prevent long-term
According to the National Institute of Neurological Disorders and Stroke, the five sudden, distinct symptoms of a stroke are: • numbness of the face, arm or leg (usually on side of the body) • confusion, difficulty speaking and understanding speech • difficulty seeing in one or both eyes • difficulty with walking, dizziness, or loss of balance • severe headache from causes unknown
Helping You Mind Your Meds
Pharmacists Erin Lewis and Aaron Kanas
The pharmacy team at Berger Health System has developed a new way to keep you safe and informed after your hospital stay.
t’s imperative a person understands the implications of any medication—including positive results and potential side effects— so Berger launched its medication reconciliation program in July 2011. Before a patient is discharged from the hospital, a Berger pharmacist meets with him or her to discuss any medications that have been prescribed. The pharmacist reviews when and how often the patient should take each medication. Berger’s goal is to coordinate the patient’s medication transition to home as safely as possible. “It’s our goal to clarify information and make sure patients know how to take their medications and get them filled,” said Aaron Kanas, RPH, director of pharmacy services at Berger. “This extra step helps patients remain on track with their care plans and reduces readmissions.”
After a week back home, each patient receives a follow-up call to see if he or she has experienced any problems with medications or further health issues. “Since this program began, we’ve been able to reduce readmissions by nearly 50 percent,” Kanas said.
Leading-Edge Care at the Bedside In addition to the discharge medication reconciliation program, Berger also utilizes mobile technology—known as the “workstation on wheels” (WOW)—when pharmacists consult with patients. This top-ofthe-line technology allows pharmacists to direct patients with greater accuracy and access important information at a moment’s notice. “When our pharmacists are doing rounds with the WOW, they can access not only the patient’s electronic health records, but the best clinical research electronically,” Kanas said. “Many tasks once performed in the pharmacy can now be done at the bedside.” Visit www.bergerhealth.com to find out how we’re using technology to make state-of-the-art care personal for you and your family.
Providing a Safe Experience At Berger Health System, our discharge medication reconciliation program serves a great purpose: to keep you informed and safe as you transition to the comfort of your home following an illness or procedure. Our pharmacists are ready to answer any questions or address concerns you may have. 4
Be an involved Patient Being an informed patient means asking questions or requesting additional information. “We encourage patients to be persistent and be partners in their care,” said Aaron Kanas, RPH. “The more patients know, the more empowered they are to maintain control of their health.” Ask your physician or pharmacist about: • any new medication, including why you’ve been prescribed the medication and any side effects or interactions that could occur • changes in dosage or frequency, as you may reduce these for certain medications after your initial discharge from the hospital • how over-the-counter products—such as cold and allergy medications, herbal supplements or vitamins—could interact with your new prescriptions • how to dispose of medications properly once they’ve expired Still have questions? Reach a Berger Health System pharmacist by calling 740.420.8247.
Establishing a patient-centered medical home for your family puts you in control of your care, allowing you to work one on one with a primary healthcare provider on the road to better health.
esearch from the University of California, Davis has found that people with access to comprehensive, expanded-hours, patient-centered care have a lower risk of premature death. These elements are central to a medical home—a model that provides a wide range of services including acute, chronic and preventive care.
“A patient-centered medical home provides one-on-one care with a designated physician, offering patients more individualized attention,” said David McMahon, M.D., FACP, internal medicine physician at Berger Health System. “Focused on a long-term relationship, physicians take time to determine each patient’s needs. Physician and patient work together to meet the goal of staying as healthy as possible.”
A Certified Program Dr. McMahon’s practice was certified as a patient-centered medical home in January 2012 by the National Committee for Quality Assurance. With this model, patients have greater access to care through features such as 20-minute office appointments and availablity of same-day and short-notice appointments to accommodate patients’ needs for timely care. “The concept of a medical home makes intuitive sense and is something I have been practicing informally for several years,” Dr. McMahon said. “Achieving the certification took about a year, and we did not need to change much about our practice except how we documented patient-centered care already in effect.”
Get Your Home in Order Dr. McMahon is one of three Pickaway Health Services internal medicine physicians located at Berger Medical Center who specialize in the general health care of adolescents through senior citizens. Women of childbearing age might choose a Berger-affiliated internal medicine physician or OB/GYN who can address specific women’s health concerns. Pediatric services are also available with Berger. Advantages for patients choosing a medical home at Berger Medical Center include the close proximity of diagnostic services such as X-rays, computed tomography (CT) scans and magnetic resonance imaging (MRI), and a laboratory for blood work and other tests. “Many times when I send a patient downstairs for an X-ray, I receive the results from a radiologist before the patient returns to my office from the convenient procedure area,” Dr. McMahon said. “The ability to get things done quicker, more efficiently and with the latest technology is what you get at Berger.” For more information about Berger’s philosophy of care, visit www.bergerhealth.com and select “About Us” and “Mission / Vision.”
Medical HOme 101 A patient-centered medical home provides one point of contact for medical care and the expertise to navigate treatment, should a patient’s needs become more complex. According to the Ohio Academy of Family Physicians, the features of a patient-centered medical home include: • coordinated care • enhanced access to care • a personal physician • quality care • safety • whole-person orientation • the patient as a partner in their care
Our Next Stop on the Road
to a Digital Destination Berger Health System has been well ahead of the technology curve with implementation of electronic medical records (EMR) more than a decade ago. Today, the next technological advance has been realized.
Stephanie Bode, RNC, BSN, Shankar Kurra, M.D., and Tiffin Barthelmas, RN, MBA
erger recognized the importance of digital records long before the American Recovery and Reinvestment Act of 2009 mandated that physicians and hospitals demonstrate meaningful use of an EMR in order to receive full Medicare/Medicaid reimbursements in the future. We began putting our EMR in place in 2000, and today, patients appreciate the benefits of a digital records system that extends to all clinical areas of Berger. “Our EMR is a living, breathing system, and we’re constantly enhancing it,” said Andy Chileski, chief information officer at Berger. “Digital records allow physicians and other providers to access complete overviews of patients’ health simply by pulling up their health information on a computer or other electronic device, eliminating the inconvenience of having to obtain paper records from other locations. Put simply, the EMR gives providers one place to go to view patients’ medical histories, which allows them to spend more face-to-face
time with patients.We use technology to enhance personal delivery of care.”
(Digital) Orders Up! With an EMR in place, our physicians needed to be able to perform patientcare tasks such as ordering imaging tests and medications electronically. Enter computerized physician order entry (CPOE). As with our EMR, we chose MEDITECH as our CPOE provider. When our hospitalists began using the system during the first phase of implementation last November, Berger became, according to MEDITECH, part of the estimated 2 to 5 percent of U.S. hospitals working with CPOE systems. “If, for example, a patient arrives at Berger with chest pain, a physician uses CPOE to pull up an order set for that condition, which has been built using clinically based evidence and includes best practices for treating the patient’s symptoms,” Chileski said. “The order set may include medications, imaging exams and laboratory tests. The physician can choose to implement the whole order set or pick certain components of it, depending on the situation. CPOE speeds the ordering process so that the physician can coordinate care and get the patient’s treatment under way.”
Bridging the Gap Between Clinical Care and Information Technology Two members of the management information systems (MIS) team at Berger played important roles in the implementations of EMR and CPOE. However, they didn’t always spend their days pondering the userfriendliness of electronic records and orders systems. In days past, they helped welcome our newest patients to the world. Eight years ago, Tiffin Barthelmas, RN, MBA, analytics supervisor at Berger, joined MIS from our labor and delivery department—the first Berger department to adopt electronic documentation for
nurses. Like her nursing colleagues, Barthelmas had to adjust to performing tasks electronically rather than with pen and paper. When the opportunity presented to help build the electronic nursing documentation system and train her colleagues to use it, Barthelmas knew she wanted to be a part of it. She was convinced that her understanding of bedside nursing was key to using technology wisely. Barthelmas has helped bring each milestone in digital care to fruition since she joined MIS, including the implementation of digital nursing documentation on inpatient floors in 2005, the introduction of bedside medication scanning and bringing our emergency department into the electronic documentation fold. Along the way, she’s used her clinical experience to inform the technical process. “An idea that looks good on paper in the world of technology may not mesh well with the workflow reality in the clinical world,” Barthelmas said. “Having individuals in MIS who come from nursing backgrounds makes the digital transition easier for everyone and, most importantly, more beneficial for patients.” Like Barthelmas, Stephanie Bode, RNC, BSN, systems analyst at Berger, moved from the labor and delivery department to MIS in 2010 to pursue her interest in the electronic side of nursing. Bode provided on-site support at physicians’ offices when practices implemented EMR in fall 2010.
Barthelmas credits Bode with playing a key role in developing order sets for our CPOE system that ensure all patients receive standardized, evidence-based treatments, depending on their diagnoses. “It has been gratifying to help physicians and nurses embrace CPOE and show them that using it can become second nature,” Bode said. “I feel privileged to have been involved with this because our patients deserve nothing less than the best system we can give them.” To keep up with the latest news from Berger, visit www.bergerhealth.com.
How Do I Benefit From EMR and CPOE? The answer comes down to two important aspects of patient care: safety and efficiency. On the safety side, electronic records and orders: • eliminate the guesswork—and potential for error—that comes with deciphering handwritten orders and prescriptions • ensure patients receive evidence-based care according to their diagnoses • reduce the possibility of harmful interactions between medications through automatic checks and safeguards Understanding the efficient side of electronic records and orders is simple: If a physician can access a patient’s medical records and file orders from anywhere—even the bedside—he or she has more time to spend helping the patient get well.
Your Health Information at Your Fingertips Annette Perry, CNP
ffered at 15 outpatient physician offices affiliated with the system in addition to the main Berger facility, the patient portal ensures convenient access to medical records, up-to-date health information and more. By logging on to a highly secured patient portal, patients are able to review pertinent information and share their medical histories with physicians in a timely manner. “The portal benefits both parties,” said Sally Galecki, operations director at Pickaway Health Services. “Physicians no longer have to wait for a fax to come through to obtain medical information, and patients can have immediate access to that information via the portal once it’s entered by their providers. That same online access allows providers to treat and diagnose patients more efficiently and effectively.”
Increasing Transparency The implementation of patient portals at Berger has increased patient quality, safety and satisfaction. “When patients have access to their medical records, they become participants versus observers in their health care,”
Committed to providing patients and providers with easy access to online medical records, Berger Health System recently launched an innovative patient portal. Galecki said. “They lend an extra pair of eyes to medical records. If they have any changes or clarifications, they’re able to immediately bring those discrepancies to the provider’s attention. From a clinical standpoint, the physician-patient partnership is a significant advantage.”
Coming Soon While the patient portal currently provides access to basic health information and medical records, Berger is preparing an expansion that will give patients even more access.
“Our goal is to continually enhance patient portal capabilities,” Galecki said. “In the near future, the portal will allow patients to change their demographic information, request an appointment with a provider, obtain a referral and pay medical bills.” While these features provide convenience for patients, they also help medical offices maintain better records and run more efficiently. To learn more about gaining access to the patient portal, consult your Pickaway Health Services provider.
Portal Process = Safety First Once patients have requested and obtained personal identification numbers (PINs) assigned by their physicians, they’re able to register for the online patient portal. After completing registration, patients can review, share and even print personal medical records. While individual patients enjoy easy access to their own information, the portal is extremely secure. “Patients can rest assured that our portal is protected and complies with the Health Insurance Portability and Accountability Act [HIPAA],” said Sally Galecki, operations director at Pickaway Health Services. “Obtaining a personal PIN from a provider is how a patient sets up an account. This process provides a secure and private portal.”
A Vital Step
for Infant Clinical Care
ccording to the American Heart Association, the lives of as many as 200,000 children and adults could be saved every year if cardiopulmonary resuscitation (CPR) is performed. To better train employees and students in infant CPR, the Berger Health Foundation Board of Directors has approved the purchase of a SimBabyTM for the Berger Health System education department. The SimBaby is an advanced infant patient simulator used for CPR training.
This realistic device allows employees and students training at Berger to perfect their CPR skills in a risk-free environment. The SimBaby creates situations for responding to different clinical cases while adjusting care plans according to immediate feedback from the device. “The SimBaby purchase is just a part of the Foundation’s commitment to Berger,” said Larry Halm, executive director of the Berger Health Foundation. “The Foundation
will continue to help provide the latest in technology and community programs for the benefit of area residents.” For more information about the Berger Health Foundation, visit www.bergerfoundation.org.
Advanced Emergency Care
at the Ready
pen 24 hours a day year-round, Berger’s ED is always available to provide urgent care for traumatic injuries and serious illnesses. The ED’s team of experienced, well-trained physicians and nurses treats more than 30,000 patients every year. “We provide community care with advanced technology,” said Tina Pierce, RN, BSN, emergency department nurse manager. “We take the time to treat each patient individually and provide highly detailed assessments. Our ED turnaround time is twice as fast as the national average. Quality care is supported by our focus on
As we observe National Critical Care Awareness and Recognition Month in May, remember that Berger Health System’s emergency department (ED) offers advanced technology and a medical team that combines efficiency and comfort. being there for our patients’ immediate needs.” In 2010, Berger also became the first healthcare facility in the area to be recognized as an Emergency Center of Excellence™ after meeting more than 100 benchmarks evaluated by Emergency Excellence, an organization specializing in ED performance evaluation.
The Stroke Care Advantage As part of Berger’s recent partnership with OhioHealth, the ED received a stateof-the-art TeleStroke system in March. The new system allows neurologists and stroke-care experts located at Riverside
and Grant tertiary centers in coordination with on-site Berger experts to diagnose and treat stroke patients, allowing patients to receive lifesaving treatment faster. “When a patient suffering a stroke or stroke-like symptoms comes to the ED, time is of the essence,” Pierce said. “His or her risk for permanent brain damage from a stroke increases with every passing second. TeleStroke helps us determine an appropriate course of treatment in a more timely manner.” For more information about TeleStroke and Berger’s partnership with OhioHealth, turn to page 3. www.bergerhealth.com
Prevail over Pain
with Interventional Radiology For many areas of treatment, gone are the days of large incisions, lengthy surgeries and even lengthier recoveries. Thanks to the interventional radiologists at Berger Health System and the technology at their disposal, surgical procedures are now performed with more ease and less pain.
nterventional radiology is a specialty that uses image guidance through X-ray, ultrasound, and computed tomography (CT) to conduct minimally invasive targeted procedures. Since these procedures aren’t as traumatic as open surgery, numerous health benefits are available for patients, including: • faster recovery
• lower risk of complications
• less external scarring
• shorter procedure time
• less pain “Interventional radiology procedures can assist in the treatment of a wide variety of conditions in the body, including peripheral vascular disease, certain cancers, kidney disease and varicose veins,” said Eric Dolen, M.D., director of interventional radiology at Berger. “However, one of the most common uses of interventional radiology is to manage and relieve pain, especially in the back and joints.”
Making Life a Little Less Painful If you suffer from chronic back or joint pain related to issues such as osteoporosis, arthritis or degenerative disc disease, then you may benefit greatly from pain-relieving procedures through interventional radiology, including: • Vertebral augmentation—Osteoporosis can cause painful compression fractures in the spine. This procedure relieves pain when surgical bone cement is injected into the bone to stabilize the fractured area.
Eric Dolen, M.D.
A Full Spectrum of Care Interventional radiology includes a wide scope of treatment options to provide minimally invasive alternatives to more traditional surgeries. These procedures include: • central venous access—method to supply medicine to patients requiring dialysis, chemotherapy, intravenous feeding and longterm antibiotics • endovenous laser treatment—outpatient procedure to provide relief for varicose veins • filter placement for blood clots—reduces blood clot risks by blocking the clot before it affects the lungs or heart • PVD—treatment of peripheral vascular disease including angiogram, angioplasty and stents
• Epidural steroid injections—Patients with degenerative disc disease, herniated discs or spinal stenosis can undergo this procedure, which involves injecting steroids into the affected area to decrease inflammation and swelling around the nerves. • Medial branch block—To diagnose certain conditions, such as facet joint arthritis, this procedure involving a local anesthetic injected around targeted nerves can block pain reception in the nerves and determine certain causes of pain. 10
If you experience chronic back pain, speak with your primary care physician about interventional radiology painrelieving procedures or call 740.420.8181 to schedule a consultation with a Berger interventional radiologist.
Lifeline Award Lifeline of Ohio recognizes the contributions made to the community by the Berger marketing department.
erger’s marketing department was one of several individuals and institutions honored Saturday, March 3, 2012, by Lifeline of Ohio for their roles in saving lives through organ and tissue donation. Thirteen awards were presented by the federally designated organ-procurement organization at the 10th annual ceremony, “An Evening with the Stars,” at the Blackwell Center in Columbus. Each award was introduced by a local individual whose life has been touched by donation. Among the presenters were donor family members, organ and tissue transplant recipients, and a transplant candidate. Berger was honored with the Hospital Marketing Department Award, acknowledging the comprehensive support of a hospital public relations and marketing department in promoting donation. Berger received the award for exceeding Lifeline of Ohio’s expectations in helping promote donation not only to the hospital, but also in the community at large.
Clockwise from top left: Tiffany Bauman, Shea McMahon, Susan Strawser, Natalie Yakunich, Sandi Nunley, Suzanne Welker and Kyleen Valone
Joining an Elite Group Gregory K. Lam, M.D., cardiologist at Berger Health System, was recently recognized as one of Columbus Business First magazine’s Forty Under 40 award winners.
or 20 years, Columbus Business First has gathered a group of six panelists to select local young professionals who are making a difference in their community and beyond. Along with 39 honorees from medical, financial and nonprofit backgrounds, Dr. Lam was recognized for his service and expertise in May at the Columbus Athenaeum, as well as in the May issue of Columbus Business First.
Inspiring a New Vision of Care Since joining the medical staff three years ago, Dr. Lam has helped form a partnership with the OhioHealth Heart and Vascular program. He also set the stage for the cardiac care unit at Berger, where patients
can receive comprehensive care for their hearts. His hard work and direction led to the opening of the cardiac center in fall 2011. Before settling in Ohio, Dr. Lam received his medical degree from University of Rochester School of Medicine and Dentistry and completed both an internship and residency at Duke University Medical Center. He also served as adjunct assistant professor of medicine at Duke University and was part of the clinical faculty at Ohio State University Medical Center. To learn more about Dr. Lam and cardiology services at Berger Health System, call 740.420.8174. www.bergerhealth.com
A Dedicated Presence The continuing improvement in patient care and satisfaction at Berger Health System is due to more than our substantial advances in technology. Without our team of experts, our technologies wouldn’t be what they are today. Our Management Information Systems staff is committed to using these technologies to improve patient care and patient safety every step of the way. Over the years, many have come from different departments or organizations because they wanted to make a difference in the lives of others—and they have been able to do just that at Berger. Behind the scenes is Greg Counts, Network Engineer, and Berger Health System’s Non-Clinical Employee of the Year.
Care first. Community always.
Z IP C O 24 5 0 6
600 N. Pickaway St. Circleville, OH 43113
PRSRT STD. U.S. Postage
Permit No. 830
Published on May 16, 2012