As one of the five largest public healthcare systems in the nation – and a medical safety net for Broward County – North Broward Hospital District faces a myriad of challenges and opportunities daily to maintain and enhance its flow of information electronically.

But according to Systems Development Director Glenn J. Fell, their challenges are not unique.

“Ours are probably no different than those facing other healthcare institutions … finding the resources (both capital and personnel) required to implement and maintain the many great technologies that are available today, balanced against other equally important uses for those same resources,” he says.

“Florida has some unique challenges,” he adds, “relating to attracting the key personnel needed to support a sophisticated IT infrastructure. Due to housing costs, property taxes, etc., we have seen this prevent people from moving here – while causing some people already living here to move out of the area.”

But Fell, and NBHD, are seizing the opportunities at hand.

“We have a clear path that we want to pursue relating to electronic medical records – or EMRs. This includes continued automation of clinical information so it is readily available to providers, implementing a medication administration process with automated safety checks, linking biomedical equipment electronically to the medical world, and increasing a clinician’s ability to perform their workflow electronically – to name a few.”

“All of which will improve efficiency, patient care and patient safety,” he adds.

In the last 20 years, technology has almost catapulted us into a new world, and that advancement has had a particular impact on Information Technology.

Fell says, “Improvements in wireless connections have afforded opportunities for point of care access that weren’t available in the past. The evolution of affordable, faster communication methods such as DSL, cable modems and data enabled cell phones now make remote patient record access a practical proposition for all providers – including access to clinical results and electronic images.”

He continues, “The Internet use by both providers and patients has exploded the access to a wide variety of knowledge content and has made the use of computers for ‘health’ related purposes commonplace among a significant percentage of the population.”

More accessibility translates to more efficiency – in a hospital setting, in the physician office … and even in the field.

“More data is becoming electronic every day, and more affordable methods to access that data remotely are available. For example, radiology images are now available to a physician electronically so that they can examine these from their offices or even from their homes. Not only can they see results sooner or without having to drive to the hospital, they can use the sophisticated tools that are part of the viewer program to quickly and easily manipulate the image.”

At A Glance Glenn J. Fell Director, Systems Development North Broward Hospital District How many years at North Broward? 17 Community (where you live): West Boca Raton Family: Wife, son (19) daughter (21) Education: Masters, Healthcare Administration. What would you advise someone going into the medical IT field? It’s a very challenging field but with lots of exciting opportunities ahead. No two days are the same and it’s never boring. It’s stressful because there are always many more systems and technologies requested by users than you can deliver. That said, it’s very rewarding to see the positive impact on both providers and patients when you are able to provide new technologies

This is also a benefit in the office where physicians can see results as soon as they are available, which could lead them to make a treatment modification sooner and, ultimately, get the patient out of the hospital sooner – saving time, saving money.

The emergence of advanced electronic transmission has also impacted the pre-hospital arena. Some EMS units have the ability to transmit EKG data from the field.

“These go directly to our emergency rooms,” Fell says.

Other trends on the horizon?

“We’ve seen, of course, an incredible growth in the use of the Internet for medical information, but a more recent development in early pilot stages in some areas is it’s use by patients to communicate directly with their physicians and vice versa, leading to what is sometimes referred to as ‘e-visits.’ Some insurance companies are experimenting with reimbursement for things like this.”

“Also, the creation of health records beyond the walls of one institution is a trend now being explored in various communities. Regional Health Information Organizations (RHIO) or Health Record Banks (HRB) are terms describing some of these efforts – as well as patients contributing on-line to their own personal health records.”

Another trend is a move to greater “transparency.” This includes things like web sites where a provider’s outcome statistics are posted for the public, or “pay for performance” programs where providers are paid differently based upon various outcome statistics or their use of certain technologies.

Patient privacy is of paramount importance at NBHD – and everywhere, however.

Fell says, “As we expand beyond the confines of just one organization and towards a regional – or even national – health record, our challenges expand. Not only so we have the usual access security issues on a broader scope, but there is the added issue of patient identification. We need to have some ‘clean’ identification mechanism to assure that the right patient data being fed from different places gets associated with the right patient record. However, people have a concern about having a unique national identification number for health record purposes because of privacy concerns.”

And where does Glenn Fell see all of these trends heading?

“It depends on how far you want to go. Initially, we need to finish building the ‘electronic highway’ of clinical information so that all data is digital, in a format useful and accessible to the clinicians, and where basic clinical interaction and safety rules are automatically checked all the time.”

“In the electronic record world, physicians can use that data to provide faster diagnoses, prevent duplicate procedures, have easier access to clinical reference information and protocols – thereby enhancing the ability to react faster to a patient’s changing condition.”

Whatever the technological challenges, North Broward Hospital District is seizing them as opportunities. Whatever technological trends are seen on the horizon, NBHD is interpreting them and utilizing them to best benefit their patients, physicians and their entire health community.