Medical records lead the way

President Barack Obama’s health care reform policy calls for a nationwide switch to electronic medical records by 2014.

UNC Hospitals are almost 25 years ahead of him.

What began as a pilot program in 1991 is now the Web-based Clinical Information System, or WebCIS. The Internet-based program was created by a team of UNC doctors and technicians to transfer all paper records into electronic code.

“WebCIS makes everything more efficient,” said Dr. Robert Berger, chief architect of design for the program. “Paper records were a hassle. If your chart wasn’t available, then we didn’t know about you.”

The focus of health care reform legislation winding its way through the U.S. Congress has been insurance. But the national government has expressed support for making major reforms to other components of the U.S. health care system if this legislation passes, including how records are saved.

Berger estimated the WebCIS program has cost UNC Hospitals upward of $20 million over the past 18 years. But he stressed that the benefits far outweigh the costs.

Electronic medical records allow doctors to seamlessly prescribe medication, check labs and access a patient’s medical history electronically. WebCIS also tracks a patient’s allergies and immunization history and prompts doctors when it’s time for a checkup.

Berger said he and his team decided to switch to electronic medical records as a way to keep up with technology and other industries.

“The PC was almost seven years old when the program started,” Berger said. “When it came to computers, the medical industry was in the Stone Age compared to other industries.”

Now, almost 20 years later, UNC is leading the race for electronic medical records and is one of the few institutions that has created its own system.

In a July press conference on health care reform, President Obama noted the advantages of electronic medical records but stressed they would require an investment.

Berger said while he supports Obama’s push for electronic medical records, there will be financial stumbling blocks.

“It’s a very expensive proposition,” Berger said. “The problem is that only about 10 percent of hospitals have full electronic records, so you can imagine the costs to get everyone computerized by 2014.”

Dr. Alan Cheng, a chief resident of internal medicine at UNC Hospitals, said he enjoys the daily ease of access to patient information WebCIS provides.

“As a patient, I’d rather go to a hospital with electronic medical records,” Cheng said. “I think it provides for better patient care.”

He added that although he enjoys working with WebCIS, doctors have to be careful not to use the system as a crutch.

“If we think that everything we need to know about you is online, we won’t ask questions. So we have to be careful,” Cheng said.

In 2006, UNC Health Care and WebCIS were named a laureate in Computerworld Magazine’s Honor Program. The yearly award recognizes organizations’ use of technology and information to benefit society.

“Our system has been recognized as top flight,” Berger said. “We just signed a contract with one of the top five computer companies in the world, and they’re going to sell it to other big universities.”

And further down the line, a national network of hospitals would mean a doctor could easily access the medical records of an out-of-state student here at UNC.

“If we could get this national network, then you could have tremendous benefits,” Berger said.

He added that a national network also has implications for bioterrorism and disease prevention because it allows doctors to follow trends in medical histories.

Earlier this year, the exposure of sensitive medical information from a UNC mammography study to computer hackers raised the issue of the security of computerized records. Berger said he’s confident in the measures that have been taken to secure WebCIS.

For now, he and his team continually work to improve their program.

“The days of doctor’s notoriously bad handwriting are gone,” Berger said.



Contact the University Editor at udesk@unc.edu.