Digital records: hospitals' new Rx

Hospitals and otherhealth-care providers move toward 'paperless' age.
INDIANAPOLIS (AP) -- With no patient chart in sight, Dr. Sheila Gamache strides into Thom Kolby's hospital room to check on him a day after the 54-year-old arrived ashen-faced and perilously close to death with a clogged artery starving his heart of oxygen.
Rather than flipping through a clipboard thick with pages of notations and test results, Gamache gets up to speed on Kolby's condition simply by logging onto a wireless notepad she carries on her daily rounds at the Indiana Heart Hospital.
Like a handful of others nationwide, the Indianapolis hospital has traded its once scattered medical charts, file folders, X-rays and other documents for a unified electronic records system accessible with a few keystrokes.
Federal officials, who are trying to convince more hospital executives to go "paperless," say electronic records can make hospitals more efficient, reduce medical errors and lower health-care costs.
The costs of the transition can be high, and many physicians are also unwilling to trade the ease of jotting down paperbound notations of their patients' statuses for a system that requires them to type the same information into a computer.
But concerns aside, digital records are a leap ahead for records rooted in cumbersome 19th-century filing systems.
Timely benefits
The Indiana Heart Hospital's year-old digital records system allows Gamache, a cardiologist, to show Kolby an X-ray movie of his beating heart just after he was admitted the day before with a clogged artery and in excruciating pain.
"Do you see that right there?" she tells Kolby gravely, pointing to the looped movie of the blockage displayed on a flat-screen computer in his room. "I'm not kidding, they have a name for these and they're called widow-makers."
After the checkup, Gamache sits down at a computer outside Kolby's room -- one of 650 spread across the 88-bed hospital -- to enter notes and order changes in his blood-thinning medication.
And all of it without the typical paper trail filled with scrawled physician handwriting.
Despite its digital records system, which cost $15 million to implement, the hospital is not fully paperless. It still generates paper so that it can interface with the majority of the medical community that remains burdened with paper-filled records rooms.
To cut that paper load and meet President Bush's goal of making sure most Americans have computerized medical records available within 10 years, the federal government is trying to move things along.
Nearly all hospitals do have electronic billing, but adoption of electronic health records has been slow. Just 13 percent of hospitals and 28 percent of physicians' practices had some level of electronic health record systems in 2002.
Yet the change appears to carry great benefits.
According to a recent analysis by the Institute of Medicine, the routine use of electronic records could help reduce the tens of thousands of deaths and injuries caused by medical mistakes every year.
Cut costs
Brailer said paperless systems also cut administrative costs by eliminating the need to produce, maintain and store enormous numbers of paper files.
Quickly getting patients' records online also opens the door to rapid analysis of how they are responding to new treatments, such as for cancer.
One drawback that electronic records systems pose for hospitals, however, is that they can reduce hospital revenue, Brailer said. That's because more efficient systems eliminate duplicated treatments, shorten hospital stays and get patients out of intensive care units faster.
The Leapfrog Group, a nonprofit coalition of business and other groups, is one of several organizations working to encourage hospitals to move to computerized records systems.
Suzanne Delbanco, the Washington-based group's chief executive officer, said the biggest impetus for change may come from baby boomers who are less willing than their parents to wait around for test results, demanding more efficient medical care.