Chicago's Swedish Covenant Hospital has been working on electronic records for 20 years, and advances in technology are helping the facility become more efficient and provide better care.
The hospital of the 21st Century is shaping up to be paperless and wireless, with some of the most important workers never getting tired or distracted. That's helping doctors provide better, more efficient care, but there are challenges.
While working with an asthmatic patient at Swedish Covenant Hospital, Emergency Room physician Andrew Costello frequently turns to a computer terminal, and with a couple of clicks sends data to an electronic medical record.
The record allows Costello to order a chest X-ray for his patient without ever writing on a chart or talking to a secretary to manually enter the order.
Almost immediately, an X-ray technician is notified and makes his way to the patient's room. And back at the nursing station, the doctor talks into the computer, where a speech recognition program turns his spoken words into print. That means there are no more complaints about doctors handwriting in the medical charts or on a prescription pad.
Within 20 minutes, the X-ray is in the electronic record for anyone in the ER to review, and the patient has his medicine. When the nurse typed in his name, the automated pharmacy dispensed exactly what the doctor prescribed. At bedside, the nurse made sure the bar code on that prescription matched the one on the patient's wristband. That's substantially reduced the chance of prescription errors, the hospital said.
"It's not only faster, it's more efficient," the nurse said.
And in a paperless hospital, the medical record actually helps with diagnosis and treatment.
"If you order medications the patient is allergic to, a box will pop up alerting you to this. If you bring up a template for headaches because that's what the patient complains of it will prompt you to ask questions that make sure you won't miss anything relevant."
Some of Swedish Covenant's most imporant workers never get tired, anxious, or distracted.
For blood tests, a handheld device alerts technicians to draw blood from a certain patient. When they're done, they label the test tubes with a bar code matching that on the patient's wristband.
The blood goes straight to a lab where an automated testing system takes over.
"Tubes (of blood) are placed on the line (and the) barcodes are read. So the system knows exactly what testing to run on that specimen, where that specimen came from," explained lab manager Susan Dawson. "It'll go from instrument to instrument and only stop at the instrument where it needs testing done."
These 21st century approaches to medecine are about saving lives. By saving time, Swedish Covenant said its ER wait times have been dropping since 2006.
Minutes matter for heart attack patients, so the hospital kept track of how long it takes a heart attack patient to get from the ER door to a catherization lab, where an inflated balloon opens up the blocked artery. In one year, hospital administrators say they shaved off 10 minutes.
And for patients, the benefits may be simple ones that make a huge difference.
How often do patients get the same question from innumerable people? With an electronic medical record, you explain it once, and then the history is there for anyone to read..
The government has committed $20 billion of taxpayer money to these hospitals of the future, and electronic medical records are one of the pillars of president Obama's plan to reform health care.
But only a fraction of the nation's hospitals are this paperless. That's because there's a hefty price tag: one hospital alone could spend tens of millions on a project like this. And then there's the time involved. Swedish Covenant officials say they can't add up exactly how much it's spent. It started the process almost 20 years ago: and everything, including costs have changed dramatically in that time.
Costello remembers how it used to be.
"We would call medical records and they would bring us a thick paper chart we would peruse through. It would take a long long time. Now it's almost instantaneous," he said.
But as the country's hospitals are nudged in that direction, there are equal numbers touting its virtues and raising big questions. Take the call for one standard electronic system that all institutions use and share. The fact is, Swedish Covenant's sophisticated system can't talk to an equally sophisticated but different system at another hospital.
Bridging that gap is among the huge projects facing the health care reformers.