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New era starts at TRMC

Patient records are electronic with IQ4 project

October 2, 2011
By TERRENCE DWYER, Messenger staff writer , Messenger News

Saturday, Trinity Regional Medical Center became the first of the seven senior affiliates of Iowa Health System to implement electronic patient records. That puts the Fort Dodge-based medical center at the cutting edge of a new era of recordkeeping designed to enhance the quality of the care patients receive.

This initiative will soon make the hefty paper files that traditionally have constituted the patient record as obsolete in the hospital setting as carbon paper and typewriters are in a modern office.

Sue Thompson, president and chief executive officer of both Trinity Health Systems and TRMC, said she and her team are excited that the local hospital was selected to take the lead in this major transition at the state's first and largest integrated health system. She stressed that the change will have major benefits for patients statewide as Iowa Health brings electronic records online at all its hospitals during the next two years.

Article Photos

-Messenger photo by Hans Madsen
Krystal Van Der Brink, left, a principal trainer for the new electronic record keeping system at Trinity Regional Medical Center, looks over the program with Linda Whaley, right, who is program leader for the new system.

"The ... project is much more than the implementation of a new information technology system," Thompson said. "The project is redesigning workflow for all caregivers, improving patient safety and makes patient information more available and accurate."


Iowa Health has given this landmark project the name IQ4. That shorthand way to refer to this change is intended to reflect key features of the transformation that is taking place.

"The 'I' is for Iowa Health System," said Linda Whaley, Trinity's vice president of clinical services. "'Q' is for quality. Then the 4 (is) right information, right process for the right people at the right time."

Whaley has been charged with leading the implementation of IQ4 at TRMC. She emphasized that the electronic system is about a good deal more than recordkeeping. It has major ramifications for the quality of the health care patients receive.

"Increase the effectiveness, reduce errors are probably the two biggest things," Whaley said. "All our information is going to be at our fingertips. ... It will all be in one spot."

She said that will help ensure that each health care professional who interacts with a patient has complete and up-to-date clinical information close at hand and whatever tasks a practitioner performs are recorded in the data system at the time the service is delivered.

That was a point that Troy Martens, chief operating officer at Trinity, emphasized in a Messenger interview early this year.

"It's a transformation of how we deliver care to our patients," he said, stressing that the goal is to enhance communication throughout the hospital.

The potential for improved communication goes well beyond Trinity.

Whaley said that once fully operational, it will be possible for critical clinical information to be readily available should a patient's needs require care elsewhere in the Iowa Health network. In many cases, the physicians involved in someone's care also will have ready access to information about the patient through computers in their own offices.

Extensive preparations

Getting ready for IQ4 took months of preparations and involved to varying degrees practically everyone who works at Trinity.

"It impacts every department," Whaley said. "There isn't a department it doesn't touch."

Extensive training of physicians and all the other clinical personnel now using the IQ4 system was a key part of getting ready for the change. The process moved into high gear beginning in midsummer.

Whaley said each physician underwent nearly 13 hours of specialized training to prepare for using IQ4. Similarly, nurses and other health care professionals completed rigorous, hands-on education regarding the new system before it went live. For example, each of the hospital's approximately 300 nurses completed about 18 hours of IQ4 training.

Additional personnel are present at the hospital as the system moves from the planning to operational stage to make certain all goes smoothly. According to Whaley approximately 150 to 200 additional people were scheduled to be on campus during the last week of September and the first week of October for this purpose.

"Not at any one time, but covering 24-hour shifts continuously and extra people will be here to troubleshoot if something doesn't go right," she said. "Outside people are being brought in. Those are people from the Iowa Health System as well as Epic (the company that designed the electronic health record software)."

The process of readying the hospital for the new system also involved major enhancements in its information technology. The installation and testing of software and hardware upgrades were huge undertakings over the last few months.

Whaley said it took about four hours of work in each patient room to install the hardware.

And then, of course, everything had to be checked and rechecked before becoming operational parts of the patient care system.

"After we get them all installed, they go through two rounds of testing, hands-on testing," Whaley said.

Contact Terrence Dwyer at (515) 573-2141 or



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