(Editor's note: This new column was originally introduced in the Dec. 17, 2007, Print Edition of ADVANCE . See here for the first installment.)

With buzz words such as "interoperability," "paperless" and "Web-based" prevailing, the fact remains that health care isn't comprehensively technology-enabled ... yet. At the end of 2006, less than 10 percent of American hospitals had implemented EHRs, and a mere 16 percent of primary care physicians used them. That same year, health care spent 2 percent of revenue on IT, while other industries spend more than 10 percent (statistics from www.Wikipedia.com ).

Most Americans would never drive an El-Camino or carry transistor radios instead of iPods, yet many health care transaction processes have remained largely unchanged since the 1970s. How about your organization ... are you Gilligan's Island, Grey's Anatomy or a little of both?

As this initiative is at the forefront of the national health care agenda, it's interesting-and important-to examine where HIM departments are in the adoption process and why. This month, our three diverse roundtable panelists reveal more about their organizations' specific situations: Where are they in the process of going paperless, and what decisions and processes put them on this path? Their perspectives share both similarities and polarities.

Hebrew Rehabilitation Center , Roslindale , MA
Hebrew Rehabilitation Center is a seven-site network of sub-acute care, senior housing and health care services covering the Greater Boston Area. Hebrew SeniorLife (HSL) began its EHR implementation in 2005 at HSL's 725-bed chronic care hospital, Hebrew Rehabilitation Center (HRC). It was the start of an aggressive 5-year plan to make its entire health care network electronic, wireless, mobile and interconnected.

HRC installed Meditech hospital information system (HIS), HealthPort release-of-information (ROI) and PatientKeeper Charge Capture. It also added thousands of new computers, personal digital assistants (PDAs) and laptops on mobile carts to enable point-of-care computing. As of September, HRC became the first chronic care hospital in Massachusetts to successfully complete the rollout of computerized physician order entry (CPOE) on all 17 of its units. More than 500 staff, including physicians, nurses and ancillary staff have been trained to use CPOE. Now anything a physician orders related to inpatient care is done electronically.

Our panelist, Maxwell Agyei, RHIA, CPC , is the director of HIM and chief privacy officer for HRC. He was recently named an Action Community for e-HIM Excellence (ACE) participant, a new American Health Information Management Association (AHIMA) initiative to increase involvement and awareness of e-HIM. "I can't say enough about the benefits of EMRs. I'll do whatever I can to further enable HSL's complete e-enablement, as well as the rest of the industry's. I want to encourage other organizations and alleviate their apprehensions," said Agyei.

McAlester (OK) Regional Health Center
This Oklahoma-based, 197-bed, not-for-profit health care facility has run Meditech HIS, a "first step" to becoming paperless, since 1999; however, the EHR project is in its third year. All transcription, labs and radiology is in Meditech. Legal records are currently still paper-based, but that's about to change.

The facility recently purchased HealthPort electronic document management system (EDMS) and will be scanning records into the system starting in May or June 2008. Immediately upon discharge, the record will be scanned and electronic. Said Glenda Gore, RHIA, privacy officer, "When we began working with HealthPort, we realized how much efficiency we could gain from scanning on discharge."