Hospital providing care technologically

The hospital patient was diagnosed with a fractured neck. The treatment: a halo brace, a clunky contraption that surrounds the head, immobilizes the neck and has to be worn “for a long while,” according to Susan Gerhardt, nursing director for the surgical trauma intensive care unit at University Hospital.

The patient’s wife, however, wanted to know why they just couldn’t operate and fix the problem instead.

“So the neurosurgeon pulled up the patient’s CT scan on the computer and told her they’d have to put screws in his neck that would prevent him from being able to turn his head,” recalled Gerhardt. “She understood then.”

While the surgeon’s explanation sealed the deal, he relied heavily on computer technology to scroll through a series of scans, zooming in on the break to make his case.
“Having this flexibility at his fingertips made all the difference,” said Gerhardt.
Indeed, since about 2006, technology has worked its way into just about every corner of the University Health System, the county-owned health-care system that operates the 500-bed University Hospital and conducts more than 550,000 outpatient visits annually.

Just about everything the system’s doctors and nurses do these days is done electronically, and its computers process 6 million physician orders annually. With banks of servers holding 13 million patient records and counting, UHS is seen as a national leader in the use of technology to deliver health care.

According to the Healthcare Information and Management Systems Society, UHS is in about the top 3.2 percent of all the nation’s health care systems in electronic medical records adoption. For two years, the system has ranked in the Top 25 list of most connected health care organizations published in Health Imaging & IT magazine. And in 2008, CEO George B. Hernández, Jr. and William A. Phillips, vice president and chief information officer, won the CHIME-AHA Transformational Leadership Award for deployment of EMR technology.

The hospital system is completely networked, so physicians can access health records, lab results, X-rays — almost everything — in the hospital, at home, from a mobile device. And because these records are electronic, they’re much less likely to be misfiled or lost.
The network even allows machines to talk to the staff.

More than 300 refrigerators, for example, have monitors that send an alert if the temperature inside rises too high or falls too low. On weekends, they’ll even page clinic managers should something go awry.

The price for all this whiz-bang technology might seem high — $23 million on electronic medical records technology alone, according to Phillips. But starting early has saved UHS a bundle.

“If we were trying to put these systems in place today, it would cost anywhere from $80 million to $150 million,” he said. This is in part because the federal government has committed as much as $27 billion in incentives to help the medical community go digital by buying computers, Wi-Fi networks and other high-tech gadgets. As a result, suppliers are demanding, and getting, higher prices for products UHS bought before the rush.
Other hospital systems are jumping into the high-tech pool, too. Christus Santa Rosa’s hospitals are all electronic, except for physician ordering and physician documentation, according to Steve Martin, regional information management executive.

“We wanted to ease physicians into the technology on a read-only side, so they can get used to it before they become the ones entering data electronically,” said Martin.

The hospital system is scheduled to be completely electronic by the end of 2012.
At Methodist Healthcare System, medical equipment carries radio frequency identification tags so staff can track down what they need in a hurry.

“It’s faster to locate something like an IV smart pump or a defibrillator by glancing at a computer than by wandering up and down the hall looking into patient rooms,” said Edward Cuellar, vice president and CIO.

Technology’s touch is everywhere at UHS. Physicians on rounds cart along a COW, or computer on wheels, that takes the place of a stack of paperwork they’d previous carried with them.
With the COW, they can order lab tests, write prescriptions, update medical records. And when they do, it happens instantaneously.

“When you’re at the patient’s bedside, there’s no worry that the information on the system might be dated,” said trauma surgeon Dr. Michael Corneille. “It’s up-to-the-minute. And you don’t have to worry that prescriptions will be misread in the pharmacy.”

And the technology continues to develop.

“Soon after the iPad came out, we had doctors coming in saying, ‘Can I use this to get onto the network?’” said Phillips. “We’ve been waiting for a ‘magic device’ that would free doctors from being tethered to a computer, and this is that device.”

In the same way physicians can access the hospital network from any computer in the world, they can also do so from an iPad. To help them, Allscripts, the health system’s electronic medical records vendor, has developed a secure iPad and iPhone app that should be available by the end of the year.

And because iPads generally cost less than laptops, Phillips said the hospital will begin buying iPads or similar tablets as it replaces computers.

For all these efforts, it still hasn’t been established whether high technology actually improves patient care. But that might be because the technology is still relatively new, according to Corneille.

“It’s likely that it does,” he says, “but there’s no strong, long-term data to prove it. This is one piece of the puzzle that fits in with everything we know about improving care by preventing errors and such. But it’s too soon to say that doing X will save Y number of lives.”

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