August 23, 2009
Rural health project recognized nationally
By Mike Hasten
BATON ROUGE — A system that electronically links rural hospitals, allows doctors at LSU Health Sciences Center-Shreveport to treat patients in remote locations and puts patients' electronic records at doctors' fingertips has gained national recognition.
Advance, a national magazine for health information professionals, in its August issue selected the collaborative effort of the Louisiana Rural Health Information Exchange, the Louisiana Rural Hospital Association and the LSUHSC-S as the nation's top health information technology project for the year. The system brings high-quality health care to patients in rural central and north Louisiana.
The idea was born of necessity in 2005 following Hurricane Katrina, said Dr. Donald Hines of Bunkie, executive director of LARHIX.
"When we started the project, health care in New Orleans was in a shambles," Hines said, and the LSU hospital in Shreveport was swamped with patients that normally were sent to New Orleans. Former LSUHSC-S Chancellor Dr. John McDonald "wanted to avoid unnecessary transfers, sending patients great distances for care."
But it wasn't until 2007 that the first funding was approved — $13 million to preserve health records, develop an Internet-based system so all patient records could be accessed by health care providers and patients, and develop a way so patients wouldn't have to travel long distances for treatment.
Initially, seven hospitals were equipped to enable them to electronically connect and exchange patient data with each other and the LSU hospital. Now, 14 hospitals are linked, and 23 have telemedicine and distance learning capabilities that allow rural doctors to communicate with those at the Shreveport hospital to get diagnostic and treatment advice and training. Fifteen of the hospitals are doing telemedicine consultations.
Currently, sharing medical records are hospitals in Bunkie, Homer, Bernice, Farmerville, Delhi, Ferriday, Winnsboro, Jena, Jonesboro, Pollock, Olla, Coushatta, Mansfield and Leesville.
"The budget crunch canceled plans to add seven more this year," Hines said. The system will extend its services to others and expand into south Louisiana "when we get some money."
Hines said it has helped rural doctors practice better medicine and made it much easier on patients, who once had to travel to Shreveport for any kind of specialized care.
Prior to LARHIX, rural residents often waited from 110 to 180 days for an appointment at LSUHSC-S for specialized care. Now they wait four to five days for a telemedicine consultation.
Dr. Ishak Mansi, associate professor of clinical medicine at LSUHSC-S and medical director of LARHIX, said the system "makes access to health care much easier" and "has made specialized care available for the first time in some communities" that have no specialists.
"There are all sorts of specialties available" through telemedicine, he said. "It suddenly opens a new face of medical care for rural communities."
With the new system, specialists at LSUHC-S can examine and converse with patients and examine X-rays or CT scans. And if patients do need to come to the hospital, their medical records, including any tests that have been done, are automatically at the hospital.
"We don't have to repeat tests," Mansi said, "so it avoids lots of cost and patient discomfort."
And when a patient returns to his regular physician, everything that was done at the LSU hospital is automatically in the records.
Hines said the first big challenge was transferring doctors' paper records to a digital format, especially when a rural doctor was actively treating a patient.
"It was like trying to change a tire while the car was still rolling," he said. But once it was complete, it makes keeping up with a patient's ailments, allergies, medication and diagnoses simple.
Another challenge was that most facilities don't use the same electronic format for digital records. So, an "engine" was developed that translates all electronic languages to the same format, enabling LSU doctors to read records from any participating physician.
LSUHSC's internal medicine residency program, with an emphasis on rural medicine, is providing physicians for rural hospitals. Six third-year residents a year for three years (18 total residents) will rotate through the rural hospitals. They're supported by an internal medicine specialist on staff at LSUHSC-S.