Paperless HEALTHCARE? 1

In most emergency rooms, the doctor would grill Mom: Has he have you been X-rayed? Do you keep in mind what it showed? But in the new all-digital Children’s Hospital of Pittsburgh, doctors just clicked on the COW – a “computer on wheels” that rolls to each patient’s part. Up popped every test and X-rays the 6-month-old has had ever.

This is the eerily paperless hospital of the future, what the “electronic medical record” that President Barack Obama insists will change what healthcare looks like. No chart filled with doctors’ scribbles dangling on the bed. No hauling around envelopes filled with X-rays. No discharge with a prescription slip. Even the traditional ER patient list has changed from the white-board of TV-drama popularity to a huge screen.

By the best count, only 1 1.5 percent of the country’s roughly 6,000 hospitals use a thorough electronic record. 19 billion that the financial stimulus package offers to help doctors start. 10 million to evolve a system that enables its doctor’s check up on patients with a few mouse clicks from anywhere and use speedily up-to-date information in directing their care. Dr. Jonathan Bickel, the ER attending doctor who whipped out his laptop to check on Riley’s overnight stay.

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Look, he directed: An outpatient lung specialist tested Riley for cystic fibrosis just before his mom brought the 6-month-old to the emergency room. The specialist’s detailed exam notes strike the ER computer in hours, not the full times it takes to transcribe into a paper graph. Cystic fibrosis didn’t cause his wheezing; quick, test for another thing. Still, Children’s advancement isn’t completed.

Money, and doctors’ resistance: A report in the New England Journal of Medicine this spring named hospitals’ top two reasons for not heading digital. Dr. Ashish Jha of the Harvard School of Public Health. It’s not simply the equipment’s price. Administrators find the cash to buy new MRI machines or build new hospital wings, said Dr. David Blumenthal, the Obama administration’s new health IT director. Studies also show electronic medical records, or EMRs, can greatly enhance the quality of patient care, and reduce errors. Children’s has seen medication errors dropped 45 percent since it started automating in 2002. But hospitals won’t always recoup their investment, because a patient who goes sooner means lost revenue home.

So Congress added an adhere to the carrot of the stimulus money: Health providers that aren’t digital enough by 2015 begins shedding Medicare dollars. Blumenthal told The Associated Press he’s seeing an abrupt surge in interest. Children’s moved from a decades-old building to a new hospital in-may, a final step in its digital trip.

Some 4,000 computers range the halls. Nurses swipe patients’ wristbands with bar-code scanners to see if it is time for medication, and match the bar-coded dose to the prescription then. As well as the giant patient database lets health IT chief Dr. James Levin spot methods that need enhancing. 30 extra a handbag, when medical recommendations say few patients need them truly.

Building an EMR doesn’t just suggest buying software and flipping a change. It changes how doctors and nurses work actually, a disruption that Harvard’s Jha sees as key to even tech-savvy doctors’ level of resistance. Children’s first step: Install electronic prescribing. October 2002 In, verbal or paper purchases for medications, lab tests, X-rays, IVs finished hospital-wide. Medication mistakes immediately began shedding. But ICU doctors reported a surprise, a temporary jump in deaths among those patients transferred in from other hospitals just.

Those handoffs are a perilous time, and the doctors examined 75 deaths over 1 . 5 years to summarize in the journal Pediatrics that the death rate doubled in the five months following the computer switch. They blamed changes to their well-organized routine: Patients weren’t signed up en route, delaying medication purchases; clicking through unfamiliar software took longer; wireless computers weren’t always at the bedside.

Changes were made, but Levin said the true lesson: Get doctors to help personalize their little bit of the EMR upfront. That’s who was tapped when it was time for you to cut paper charts. EMR software, said ICU specialist Dr. Shekhar Venkataraman, who found himself a convert to the ensuing custom digital dashboard.

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