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Hospitals Going High-tech

If you haven't been in a hospital for a few years, you might be surprised at how technology aimed at making your stay safer and more enjoyable is emerging in this notoriously paperbound industry.

If you haven't been in a hospital for a few years, you might be surprised at how technology aimed at making your stay safer and more enjoyable is emerging in this notoriously paperbound industry.

Your doctor may wheel a computer into your room during an exam. Your nurse may scan the bar code on your ID bracelet before giving you a pill. If you face a long wait for a procedure, a hospital employee may give you a pager much like the ones those perpetually busy chain restaurants hand out. Your preemie may send you an e-mail.

At Bryn Mawr Hospital's new outpatient building in Newtown Square, patients can check themselves in using tablet computers. At the hospital's emergency department, RFID chips embedded in plastic tags tell staff where patients are, when they get an EKG, and when the doctor first sees them.

Doylestown Hospital's emergency department can now scan for information stored on RFID microchips embedded beneath the skin of some patients; the numbers coded in the tiny capsules link to medical records on the Internet. Cameras in Virtua Health System's four emergency departments allow neurologists to examine patients with stroke symptoms remotely. Patients at St. Mary Medical Center can order food by phone from a menu - for delivery whenever they want.

These changes in approach come in response to pressure to reduce errors, use space and employees more efficiently, and give savvy patients reasons to choose a particular hospital over a competitor.

"It's really picking up over the last three, four, five years," said Daniel Garrett, a Skippack resident who leads PricewaterhouseCoopers L.L.P.'s health-care IT (information technology) practice. "It went from kind of rhetoric to PowerPoint discussion to being much more real."

U.S. hospitals are now moving toward electronic medical records - paperless systems that make it easier for health-system employees to share information and coordinate care. Electronic records also make it easier to share information with patients and their families.

At Geisinger Health System, a national leader in IT adoption, patients can schedule their own appointments by computer. "One of the things that young people love is that you can print out your child's immunization record from home," said James Walker, chief medical information officer.

Electronic medical records at Cooper University Hospital and its outpatient doctors' offices in South Jersey mean patients have to provide their personal and insurance information only once, saving them from one of the most irritating aspects of complex medical care.

Growing sophistication in software has made some of the changes possible. It is a daunting task to connect medical and staff information across a big health system. The software has "only become pretty usable in the last few years," Walker said. Plus, prices have come down.

Hospitals, of course, always have spent lots of money on the latest imaging and surgical equipment. Besides the direct provision of care, Garrett said, most of the spending on IT went toward billing. Now, the government, insurers and patients are demanding higher-quality IT when it comes to medical records and treatment efficiency. "Why are people being forced to carry around manila envelopes with little floppy disks?" he asked.

The Hospital of the University of Pennsylvania, which is well into the transition to electronic medical records, has new systems that track the status of every patient and bed. On a recent day, the hospital was more than 100 percent full. The staff used the system to find beds for patients in the emergency department or those awaiting transfer from other hospitals. Monitors at nurses' stations help family members know quickly why Mom isn't in her room.

Maryellen Reilly, associate executive hospital director, said adopting such technology helped attract the best staff members. But it also helps the hospital use its staff more efficiently at a time when demand for hospital services is rising, the hospital workforce is aging, and payers want more for less.

"You better get smart fast or that combination of factors will put you out of business," she said.

At the same time, hospitals have to think about hospitality. That is one reason patients arriving at HUP's new admissions center later this month will get pagers. Staff members will not have to yell out names anymore, leading, they hope, to a calmer experience.

"We're in West Philadelphia," Reilly said. "It's hard to get here. . . . We better darn well make sure that the entire experience is positive."

Several hospitals across the region are converting from paper charts to computers on wheels, affectionately known as COWs. Some have stationary computers in some patient rooms. Some also have computers in outpatient exam rooms.

Because patients sometimes complain that they want their doctor's full attention to be on them, not the monitor, some doctors use the computers sparingly during exams.

A team of HUP doctors making rounds one recent morning used COWs to discuss patients in the hall, but did not take the machines into the rooms. "We feel like that's disrespectful," said Eric Goren, the team's senior resident. The doctors want to talk directly to patients while they are with them, he said, but the computers make it easier to enter orders and access information afterward.

Several hospitals also have started using bar-coded bracelets to help verify that patients are getting the right medicines. The medicines also have matching bar codes. Not all hospitals that use the bracelets do medication verification. Bryn Mawr Hospital uses bar codes to ensure that babies in the Neonatal Intensive Care Unit, or NICU, are fed only their own mother's breast milk.

On the hospitality side, visitors will see more waiting areas with wireless access. Computers for patients in rooms are still a rarity. Crozer-Chester Medical Center, though, has wireless access for new mothers and pregnant women on bed rest.

Several hospitals have signed up for CarePages, a Web site that allows families to provide information about someone in the hospital in a bloglike format.