Right now, patients at St. Charles Medical Center in Bend may be asked the same set of questions about their medical history or allergies by three or four different hospital employees – each filling out different sets of forms.

Physicians write out medication prescription orders by hand on paper, nurses research medications in reference books down the hall from patient rooms and printed lab results are hand-delivered to a patient’s file.

The practices are common in a majority of hospitals around the nation. But for St. Charles Medical Center, paper records and handwritten physician’s orders may soon be a thing of the past.

”Billing and patient administration have typically been electronic,” said Scott Brown, the hospital’s vice-president of information services.

”But the Electronic Medical Records system is more on the clinical side.”

Cascade Health Services will be spending about $12 million over the next three years to create an Electronic Medical Records (EMR) system at both the St. Charles Medical Center in Bend and at Central Oregon Community Hospital in Redmond, said Todd Sprague, the spokesman for Cascade.

As of Wednesday, Sprague said the hospital had not signed an official contract with a company to purchase such a system.

Hospital officials hope – and current research backs up their optimism – that the system will increase consistency, accuracy and efficiency in caring for patients and decrease the potential for medical errors.

Cindy Cocanower, pharmacist and manager of clinical support for the hospital, said switching to an electronic system is about putting more information at the patient’s bedside, instead of down the hall or dispersed between departments.

Such a system will allow physicians to enter orders for medications and procedures into portable laptops. Hospital employees, such as nurses and pharmacists, will then be able to access a patient’s file, which will contain those medical orders, plus a patient’s medical history, results from lab tests and X-rays.

”When the nurse is working with the patient they will have every bit of information they need,” Cocanower said.

For example, a nurse will be able to use a hand held computer to match a bar code on a patient’s wrist band with the bar code on a bottle of medication to see when the last time the patient received their medication and who administered it.

If the patient is allergic to a certain medication or the prescription may have an adverse reaction with another medicine the patient is taking, an alert will pop up on the screen warning the nurse or doctor of the situation.

Reference material on specific drugs will also be accessible through the electronic system as well as the hospital’s protocol for using certain medications. And after someone enters patient information, the system prompts them to continue with more or answer relevent questions.

”Because we’re not chasing a piece of paper through the system, we won’t have to worry about whether everybody has been through all the filters,” she said. The end result, she said, should be increased patient safety.

According to The Leapfrog Group, more than one million serious medication errors occur every year in U.S. hospitals for reasons such as illegible hand writing and decimal point errors. The Washington, D.C.-based organization works with public and private groups to find solutions to hospital systems problems, according to its Web site.

Such errors can be costly to the patient and hospital, and sometimes life-threatening, according to Leapfrog. Systems that allow physicians to enter their orders electronically reduced those errors by 55 percent, concluded a study led by Dr. David Bates, chief of general medicine at Boston’s Brigham and Women’s Hospital.

The rates for serious medication errors fell by 88 percent in a subsequent study done by Bates’ group, Leapfrog reported.

Kent Gale, president of Klas Enterprises, a research marketing company in Utah that focuses on health care software, said a survey completed in February of all the hospitals in the nation – about 5,000 – revealed less than 1 percent had fully implemented computer physician order entry systems.

Another 4 percent were in the process of implementing such systems and already reporting benefits, and a large number of hospitals were planning on purchasing such a system, Gale said.

”For those that were doing it, they had significant success with the reduction of errors,” Gale said. ”They were still in the midst of taking advantage of the system…but they were happy with what they had and expecting more (success).”

In addition to streamlining the prescription process, Dr. Dean Sharpe, medical director at St. Charles, said the new technology should could help get patient’s discharged earlier by making information physicians need to make decisions more available.

For example, if a physician sees a patient and then leaves before the patient’s lab results have been dropped into their paper medical chart, the physician won’t be able to make a decision regarding that patient until the next time he or she stops by.

The same goes for physicians waiting for X-rays or other information from different parts of the hospital.

And the information, said Jane Breuer, St. Charles’ manager for the hospital’s surgical speciality group, will be there for the patients to see as well, instead of in a chart down the hall.

”As they interview patients and do patient care it might cue patients to say Gee, can I look at my report?’” she said. ”Patients will be able to learn more about their condition.”

The Children’s Hospital of Orange County in Southern California went ”live” with the first portion of its Electronic Medical Records system last summer.

”We’re getting physicians’ orders processed more quickly and seeing (lab or test) results more quickly on the patient’s chart,” said Mark Headland, vice president and chief information officer for the California hospital.

The new technology was met with at least a little resistance at first, he said.

”It’s changing a culture,” he said. ”It’s asking nurses to key in data at the bedside instead of congregating at the nurses’ stations. It’s asking physicians to key in their own orders.”

The key, Headland said, is spending a lot of time on training.

Training, said Brown, St. Charles’ vice-president of information services, is a big part of the millions the hospital is spending on this project. But, he said, the system should also save the organization some money.

The hospital spends about $500,000 on paper forms a year, he said. He also estimated that the hospital also keeps about two miles of shelves of paper medical records in storage.

Hospital officials say the first phase the EMR system will go live by fall 2004. The long term plan, said Sharpe, is to expand the system into the region.

”The Electronic Medical Records will be able to be viewed by authorized people with an Internet connection and physicians (outside of St. Charles) will be able to view a patient’s discharge summary,” he said.

And at some point, he said, physicians with offices in Prineville, Burns or other outlying areas will be able to not only view information, but also enter theirs into the system. ”Ultimately we’d be able to wire all of a patient’s information across the spectrum,” Sharpe said.

Kelly Kearsley can be reached at 541-383-0348 or at kkearsley@bendbulletin.com.