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New Operating System: Technology changes the way doctors, hospitals work
(Messenger-Inquirer (Owensboro, KY) (KRT) Via Thomson Dialog NewsEdge) Dec. 6--Chart and clipboard? Gone. X-ray and MRI film? Kaput. A doctor rushing into the hospital to check a mother in labor's vital signs? Old and busted.
Nationwide and locally, hospitals, doctors' offices and the physicians are learning how to take advantage of technology to make their jobs easier and to do a better job of diagnosing and treating patients.
The result? Doctors are caring for their patients, even if they're not in the same room, with a higher quality and efficiency of care.
"If I'm a patient, my physician can stay connected to me, even if they're not sitting right next to me," said DeAnn Tucker, director of health information management at Owensboro Medical Health System.
Paperless paperwork
Doctors at OMHS still use charts, take notes, write prescriptions and do most things via pen-and-paper.
But once the doctors turn the charts back in, the charts get scanned, checked and rechecked -- for fuzziness, a bad scan, etc.-- and loaded into the hospital's electronic records system. Once that's done, the doctors can go back in, sign off on the chart, check records and make notes on patient care, all through the use of computers.
That means doctors don't have to spend time wading through charts, records and results. It also makes comparisons between current test results and older ones much easier since the information is all at hand.
"It's just better for them, and they can manage it better," Tucker said. "It gives them flexibility. It's much more efficient for them. Physicians have better and faster access to their information."
Patient safety is also improved, since questions about spelling or orders where prescriptions or procedures are concerned can be marked on the electronic charts. That ensures that doctors double-check and eliminate confusion.
In the future, Tucker said, paper charts will be gone entirely.
Robert Payne, a registered nurse and physician automated support team leader, said the benefits of using technology for record-keeping are almost limitless.
"It's changed medicine in the way data is now collected. It's no longer written on paper. It's definitely more legible, it's reportable and auditable. It's much easier to keep track of a patient's health information now," Payne said. "As far as the technology goes, there are more tools for them (doctors) to reference, tools to help them with decisions for medicines, procedures and clinical paths to take for treatment of their patients."
Eventually, Payne said electronic records will be the norm, especially with the government-mandated goal of a totally electronic system by 2014.
"As far as the future goes, the vision of the hospital is to have a communitywide medical record," Payne said. "That way a patient can be in one location, go to see another physician or health care provider in another and the patient's information can be shared between them to increase the quality and efficiency of patient care."
House calls, but in reverse
Dr. Maria Smith, a local obstetrician and gynecologist, often gets calls from the hospital about patients. If the need is serious enough, she goes to the hospital. In the past, however, Smith would often have to go in to check on something.
Now, all Smith has to do is get to a computer with Internet access and log in to the OMHS network, where she has access to the OB Traceview system. In the past, nurses and doctors would have to physically check readouts from the monitors placed on a mother in labor. Now, the monitors send the data into the Traceview system, so a nurse can monitor several mothers instead of just one.
"Where it used to be that nurses had to get up and go in the room and look at the strip that was coming from this particular patient's monitoring, now it's all centralized," Smith said. "They can see it at the main desk, where all the nurses can see all the fetuses monitored."
The access-it-anywhere ability is also true of the medical records system, which is one of its biggest advantages, since doctors can get to it from anywhere with Internet access with the guarantee that the secure connection keeps patient data safe and secure.
"It doesn't matter if they're out of town or at home," Tucker said. "All they need is a high-speed Internet connection."
It also increases the convenience for doctors, allowing them to review a patient's medical history before they see the patient, even if they haven't yet started the day at the hospital.
"They can actually review the entire history of the patient from home to get the historical picture before they come in to treat them," Tucker said.
The benefits from this come from all sides, Smith said.
"It offers the nurses some reassurance that we can look and back them up ... I can look at vital signs, her (the mother's) blood pressure, her heart rate, and I can look at that all instantly," Smith said.
Patients, Smith said, also like the arrangement.
"They feel reassured. They feel like I'm on top of it," Smith said. "As nervous as pregnant women and women in labor can be, that's one less thing they have to worry about."
Picture-perfect diagnosis
A few years ago, Dr. Charles Bea would look at a series of images on a film sheet, mentally ordering them and viewing each one in sequence to find a patient's problem.
Today, Bea, a radiologist working at OMHS, sits in a dim room in the nuclear medicine department at OMHS and with a couple clicks of the mouse, can let the machine do that for him, with his access also being possible from computers with the correct software and an Internet connection.
"We just click with our mouse and bring up the images," he said, adding that it allows him to consult with other doctors, even if they're hundreds of miles away. "It helps because we can view images from any imaging station. We don't have to be in the hospital. We can consult with doctors in Chicago."
The images on the computers are also of a much higher quality, Bea said, making it easier to spot the problem he's hunting for.
"It helps us make a more accurate diagnosis," Bea said.
A fringe benefit of this is it also makes it easier to see any other unexpected problems in the picture, which means patients can get needed, even lifesaving, treatment faster.
"We are picking up more incidental findings," Bea said. "It helps in so many ways to improve medical care, and at the same time it saves on costs (of materials for film development)."
The images go from the X-ray machine, the CT scanner or the MRI machine straight into the computer system, eliminating the need to track them down and handle film.
"The images are immediately available, so I can do the reading in a more timely way," Bea said, adding that the system is also laid out so that if there are many urgent readings needing to be done, doctors can see that and pitch in to help.
"Nothing replaces putting your hand on the patient"
The system isn't foolproof, but it's not riddled with problems either. As with most technology, there are bound to be hiccups and occasional glitches, but these problems have never caused a patient's care to be jeopardized, Tucker said.
Smith said she's used the system extensively and it's proven itself reliable and useful.
"Do I trust the equipment that we currently use today, yes I do, because the equipment such as the fetal monitoring has been studied, it has been watched," she said. "While it's not going to tell you absolutely that there is a baby in trouble or that this baby is absolutely perfect, there are indicators you can get that help you know if you need to evaluate further. It's just kind of a tool to help us."
Smith added that she is absolutely OK with the one thing a computer can't do: Replace the human element of medicine.
"Nothing replaces putting your hand on the patient," Smith said.
Smith said she looks forward to the increasing capability of technology. Within the next year, she said, the hospital's network should allow her the ability to access patient records, charts and the Traceview system from her "smart" phone, a combination of hand-held computer and cell phone. Making good use of technology just makes her job easier, she said.
"It certainly makes me more efficient and I think it also helps the nurses knowing that while I'm a phone call away, it's not going to take me seven minutes to get to the hospital and up to look at something that's concerning them," she said.
"It's putting the patient first," Tucker said. "We are trying to help the physician get information faster and more efficiently and in the end, it's for the patient."
To see more of the Messenger-Inquirer, or to subscribe to the newspaper, go to http://www.messenger-inquirer.com.
Copyright (c) 2007, Messenger-Inquirer, Owensboro, Ky.
Distributed by McClatchy-Tribune Information Services.
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