With major parts of the Affordable Care Act going into effect October 1st, the health care industry is in a state of flux. But while new requirements for health insurance have garnered much of the attention, they’re only one part of the changing landscape.
Deb Bass has a big job: organizing the sharing of medical data between hospitals and clinics throughout Nebraska.
And she’s been busy.
“We have a number of the critical access hospitals that are now signing up,” she said. “Creighton, O’Neill, Beatrice, York …”
Giving Nebraska's Health Care the Digital Treatment
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Photo courtesy of Central Community College
Students in the dental assisting program practice in the simulation lab.
So far, one-third of physicians in the state and 51 percent of beds in licensed facilities are connected to the network, known as the Nebraska Health Information Initiative, or NeHII. Bass, the executive director, said they’re aiming to connect 80 percent of beds in the next two years.
“We can share lab results. We can share transcription reports. Progress notes,” she said, ticking off the different kinds of data included in NeHII. “When you’ve had an operation, the note that describes what happened to you. Radiology images. If you’re traveling across the state and you’re involved in a car accident and you have broken bones, we can get those reports so that when you go back to your local doctor, he can see exactly what happened to you.”
This isn’t your grandparents' healthcare system, or even your parents'. The healthcare industry is changing every day, all around us, in large part because of the growing involvement of digital technology.
Just ask Mary Patricia Kuehler, a nursing instructor with Central Community College in Columbus, in east-central Nebraska. She said things have greatly changed in the 13 years since she was a student: “You know, everything was paper (and) pencil, paper charting, black ink, et cetera,” she said with a laugh. “Nurses today, we really have to be adept at working with computers, not being intimidated by them.”
From analog to HD
The cutting edge of technology
These photos from the University of Nebraska Medical Center show the kind of robots used in modern surgery.
Some of these big technological changes in health care, like Bass’ work building the health data network, have developed behind the scenes. Others are harder to miss.
“People, when they think of robots, think of the Jetsons and the robot cleaning lady,” said Dr. Dmitry Oleynikov, professor of surgery and director of minimally invasive and robotic surgery at the University of Nebraska Medical Center in Omaha. “This is not how it works today; perhaps in the future it’ll work this way.”
Instead, he said, “what occurs is that the machine essentially does what you tell it to do … it’s probably no smarter than your automobile. You press the gas, and the car goes, you press the brake, and the car stops.”
Oleynikov compared technological changes in medicine to the transformation of television, going from analog to digital to HD.
Electronic health records
But these changes don’t come without struggle – just look at the switch from paper records to digital records.
Dr. Peter Lueninghoener opened Elkhorn Valley Family Medicine in the north-central town of O’Neill, Neb. about 8 years ago, and from day one, they were using electronic health records, or EHRs.
“There’s been a lot of challenges,” Lueninghoener said wryly. “Nothing like this comes very easy. The first challenge, when we opened the door, was to convince my nurse and office manager that we didn’t want to go with paper, that we were going to go electronic, and show them that it could be done.”
Rural vs. urban
There are added challenges for rural areas looking to incorporate greater technology – such as sufficiently fast broadband internet, or access to technical support.
How comfortable health care workers are with new technology varies between rural and urban areas, too – and between different kinds of training institutions, such as those that attract nontraditional student bodies versus traditional. While a UNMC professor chuckled when recalling teaching students how to use a computer mouse 15 years ago, for Columbus nursing instructor Kuehler, teaching basic computer skills is still a reality.
“In my course, I try to go through just a real simplification of, you know, how do you save something? How do you make it easily accessible? How do you upload things?” she said. “We kind of go through that the first day of class. Because while some of them have gone straight through, others have been out of school for months, weeks, years, decades, even!”
“A fundamental change”
Even for those more familiar with technology, or who have the technological support available to fill in the gaps, the current restructuring of healthcare still takes time and effort.
“It has to be a fundamental change in the entire industry,” Bass with NeHII said, her tone serious. “And change is difficult. And change is uncomfortable.”
But increased use of technology in healthcare isn’t going away. If anything, it’ll become ever more ubiquitous … and healthcare providers, and patients, will have to adapt.
Editor’s note: This story is part of a weeklong in-depth report on technology and healthcare in Nebraska, “Giving Nebraska’s Health Care the Digital Treatment.”