Giving Nebraska’s Health Care the Digital Treatment

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September 11th, 2013

Robot2

These photos from the University of Nebraska Medical Center show the kind of robots used in modern surgery.

Lincoln, NE — With major parts of the Affordable Care Act going into effect October 1st, the healthcare 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.

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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– Creighton, O’Neill, Beatrice and York,”Bass said.

So far, one-third of physicians in the state, and 51 percent of beds in licensed facilities, are connected. Bass is the chief executive officer for NeHII, or the Nebraska Health Information Initiative. They’re aiming for 80 percent of beds in the next two years.

“We can share lab results, share transcription reports and progress notes,” Bass said. “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 grandparent’s healthcare system, or even your parent’s. 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 says 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,” Kuehler said. “ Nurses today, we really have to be adept at working with computers, not being intimidated by them.”

From Analog to HD

Some of these big technological changes, like Bass’ work building the health data network, have developed behind the scenes … others, are harder to miss.

Like robots.

Dr. Dmitry Oleynikov, professor of surgery and director of minimally invasive and robotic surgery at the University of Nebraska Medical Center in Omaha, said people when people think of the robots, they think of the Jetsons and the robot cleaning lady.

“This is not how it works today; perhaps in the future it’ll work this way,” Oleynikov 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 the technological changes in medicine to the transformation of television, from analog to digital to HD.

Electronic Health Records

But these changes don’t come without struggle. Take the switch from paper records to digital.

Dr. Peter Lueninghoener opened Elkhorn Valley Family Medicine in the north-central town of O’Neill, and from day one, they were using electronic health records, or E-H-Rs.

“There have been a lot of challenges,” Lueninghoener said. “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

And there are added challenges for rural areas – 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. While a UNMC professor chuckled when recalling teaching students how to use a computer mouse 15 years ago, for Kuehler, that’s 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,” Kuehler said. “So 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”

And even for those more familiar with technology, or who have the technological support available to fill in the gaps, the current restructuring of healthcare is still not easy.

“It has to be a fundamental change in the entire industry,” Bass said. “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.

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