By BETTY ADAMS
Staff Writer Friday, March 09, 2007

enlarge Staff photo by Joe Phelan

Dr. Dan Mingle holds up a laptop computer similar to the ones used in MaineGeneral offices. It can be used as a tablet with a stylus or flipped around and used with a keyboard like a regular laptop.

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Dr. Dan Mingle, a family physician who heads the technology department at MaineGeneral Medical Center, is leading the central Maine health-care provider's changeover from written to electronic medical records.

"Our goal is to get a single community chart for each patient," he said. "One patient, one chart, anywhere in the MaineGeneral system and theoretically elsewhere."

Access to the records would be available once a person registers for care. The electronic chart would list the person's medical history, current medications, allergies, previous procedures, etc.

The end result, Mingle said, improves patient safety, costs and quality of care and is more efficient.

Some 100 doctors with 15 practices affiliated with the hospital use the TouchWorks program for electronic records for 48,000 patients, Mingle said.

"Our targets are 140,000 patients that look to MaineGeneral for care," he said.

That means 250 doctors in 112 practices. MaineGeneral has hospitals in Augusta and Waterville and family practices in Winthrop and Gardiner.

"I teach all the doctors how to use the electronic medical records," Mingle said. "Access to computers is critical. You can't afford to have anyone waiting for a computer, and all the staff have to have access to computers as well."

Dr. Kristin Holm, a pulmonologist with MaineGeneral Medical Center in Waterville, is a new, enthusiastic user of the system.

"As a specialist, every time I see a patient in the office my 'note' or record of our visit is sent back to the primary provider to keep him or her informed about my impression, treatment and plan for the patient," Holm said.

The system also allows her to show patients their X-rays and other test results on her computer.

Keeping track electronically carries a cost.

"It can cost a practice in the vicinity of $20,000 a year for one doctor to implement electronic medical records," Mingle said, adding that MaineGeneral will subsidize up to 85 percent of software and support costs for doctors in private practice "because it's such an important project for the community."

While not every doctor or office has the electronic tablet Mingle proffers (the size of a clipboard, it looks much like a laptop and recognizes Mingle's handwriting), Mingle said all practitioners will be able to do electronic prescribing.

The hospital is one of 10 health-care organizations in the country participating in an effort known as National ePrescribing Patient Safety Initiative, which makes electronic prescribing software free to all doctors nationwide.

The project is aimed at decreasing errors that could occur with hand-written prescriptions.

Dr. Mark Rolfe of Winthrop Family Practice has been using the electronic medical record system for four years, starting with the electronic prescribing functions.

"I can safely say our quality of care has definitely improved," he said. "It's Web-based, so we have access at home, at the hospital, in the office."

Winthrop Family Practice installed wall-mounted computers in each examination room.

"We were worried at first about whether (patients) felt it was an intrusion in the room," Rolfe said.

Instead, doctors found patients are impressed with it.

"They often look over our shoulder to see," he said. "They'll say, 'The medication list looks correct.' "

Rolfe said he listens to a patient, looks at the patient and then reads the note aloud as he writes it.

He said the biggest benefit is the system's ability to pick up medication interactions, offer data about tiers of copays for medications and keep track of refill timing.

Helping to jump-start the wider use of electronic prescriptions are Allscripts Healthcare Solutions, a medical software company, and Dell, Inc.

The software being made available to physicians offers current information on medicines and also indicates the medicines covered under the patient's prescription benefit plan.

Mingle said the electronic prescribing is a major step in improving patient safety.

"By writing prescriptions electronically, doctors and other providers can avoid many of the mistakes that accompany handwritten prescriptions, as the software ensures that all the necessary information is filled out -- and legible," says a July 2006 report from the National Institute of Medicine.

The authors of the report recommend that electronic prescribing be used by all health-care providers and pharmacies by 2010.

Health-care organizations in Massachusetts, Illinois, California, Mississippi, Tennessee, Louisiana, North Carolina, Nevada, Florida, and Washington, D.C., also are promoting the free electronic prescribing program.

Betty Adams -- 621-5631

badams@centralmaine.com