Location: Plainville, Kansas
Outreach Dept: RHES
Program: Kansas Bridging Plan
Rural Kansas doctor a leader in the transition to electronic records
An April 11, 2009, article in the New York Times lauded Jennifer Brull, MD, of Plainville for being a “step or two ahead” of the majority of her profession, even those in metropolitan areas.
It took Dr. Brull a couple of years to convince the two other physicians in Plainville, population 2,500, to take the plunge into converting their records from paper to computer.
Dr. Brull and her colleagues Lynn Fisher, MD, and Dan Sanchez, MD, have discovered multiple benefits to the transition: Not only is it more efficient to be able to access records from anywhere, they can also better track patients with chronic illness, send prescriptions to pharmacies, and even transmit X-rays to specialists.
The New York Times article stated that eight in 10 doctors still use a paper system, and that one in four physicians had no plan to switch to electronic. Many cited the start-up cost of $30,000 to $50,000 as being a deterrent. According to the article, physicians in rural and underserved areas should benefit the most from the $20 billion in the economic stimulus package that’s earmarked for information technology for the health care field.
Dr. Brull has been an advocate for electronic records since the 1990s when she was a student at KU School of Medicine. Seven years ago she set up a solo practice in Plainville, where her office is connected via walkway to the new 24-bed critical access hospital. She shares a receptionist and bookkeeping staff with the town’s two other family physicians in a community-owned building.
Even though the population of the entire county is 5,600, Plainville’s three physicians have 8,000 patients because some come from adjacent counties. The process of converting the files began with training in late 2007, and last summer college students were hired to input data from patient records.
Billing was converted in January and scheduling in February. In March, the offices closed for two days for training and implementation of charting and the final conversion.
Dr. Brull especially likes having all records with her when she visits patients in nursing homes and the ability to access records on her home computer when patients call her there. She also appreciates functions that alert her when vaccinations are due, check for drug interactions, and print out a recap of patient visits they can take home. “It’s all worked beautifully,” she said.
Dr. Brull has found an electronic system to be particularly helpful in a rural area where patient loads are large and specialists are not nearby. But practicing in a rural area was something she wanted to do ever since growing up in Grinnell, a town of 250, where her mentors were rural family physicians.
“It is more than just a job, and my patients are not just my patients,” Dr. Brull said. “They go to my church and are at my kids’ activities.”
Dr. Brull participated in the Kansas Bridging Plan. The University of Kansas Medical Center, Rural Health Education and Services, administers the Kansas Bridging Plan, a loan forgiveness program offered to residents in family medicine, general internal medicine, general pediatrics, or medicine/pediatrics residency programs in Kansas. Since 1991, the Kansas Bridging Plan has sought to encourage residents to practice in a rural community upon completion of residency training, and supports those residents with loan forgiveness.