ANNAPOLIS – U.S. Veterans Medical Center in Baltimore is a generation ahead of most Maryland hospitals: It’s the only one in the state to completely computerize patient records.
But within the next 10 years, most Maryland hospitals are likely to join its ranks, digitizing everything from physician’s notes to laboratory results and putting an end to paper patient charts.
“The entire patient record is included . . . notes, lab values, pharmacy profile and medication orders are all done by computer,” said Dr. Dorothy Snow, associate chief of staff for clinical operations and education for Veterans Medical Center. All the nation’s veterans’ hospitals have moved to complete computerization of records.
For many, the move to computers is a safety issue. With more than 1 million medication errors occurring each year nationwide, patient safety groups see them as a way to reduce errors.
The Leapfrog Group, a patient safety company based in the District, said the use of computers also increases hospital efficiency.
Both the Maryland Pharmacists Association and the Maryland Hospital Association support computer systems like the one at Veterans Medical Center, but oppose any move to make such systems mandatory saying it’s expensive and time-consuming.
“The concept is one that, in general, Maryland hospitals endorse, but the implementation is the part that takes some time,” said Nancy Fiedler, spokeswoman for the Maryland Hospital Association.
For a hospital to become fully computerized, several component pieces are necessary. Many hospitals in Maryland are working on separate pieces, but only Veterans Medical Center has the entire package, according to Fiedler.
One part of the system enables an entire patient’s chart to be entered and viewed on a computer. Doctor’s notes, laboratory results, pharmacy profile, medication orders and radiology reports are all computerized so a physician can access the information from a laptop. This method virtually erases the possibility of lost or misplaced charts, unreadable notes or mismatched laboratory results.
“If I write an order, it’s transferred into a computer . . . the system allows you to look at EKGs and the cardiologist’s interpretation of the EKG,” said Snow.
Another component allows physicians to electronically prescribe medication. The system automatically intercepts errors, including drug interactions, allergies or overdoses.
“You are either typing something in or pointing and clicking, so there are no issues with legibility,” said Snow.
The Maryland Pharmacists Association said computers do not rule out error and that if a physician writes a legible prescription, it should be accepted.
“I don’t know if it will be a panacea for safety . . . there is always a chance they will punch the wrong key, so it will not completely eliminate the chance of error,” said Howard Schiff, executive director of the Maryland Pharmacists Association.
The system is not problem-free, according to Snow, even though 100 percent of the staff use the computerized patient record system 100 percent of the time.
Some staff work around the system by entering information manually, instead of using bar codes, or keeping and transcribing paper records – both of which can increase the incidence of errors.
“As with any hardware system, you have people who avoid using it,” said Snow. “We are working on diminishing that work around behavior to zero.”