St. James ER going wireless

There's a mouse in the emergency room. A mouse of the computer species, that is. The mouse has joined the ranks of stethoscopes and blood pressure cuffs as the latest tool of the trade at St. James Healthcare, said Judi Williams, director of emergency services.

Thanks to the newly installed T-System computer software program, patient charting and reporting in the ER is now state-of-the-art. The system went up on January 12 and emergency room staff is currently getting up to speed, Williams said.

"We've gone wireless," said Williams, describing the department's five new portable computer carts, which can be wheeled right to a patient's bedside. Each contains its own laptop-sized LCD screen, keyboard and mouse. With the new wireless system, data can also be entered on notebook sized computer tablets that can be held by the practitioner.

"I think it's a great system," said Dr. Richard Thorne, who is the medical director for the St. James ER through Northwest Emergency Physicians. Thorne had seen the system at conferences and was impressed. He began advocating for the new system at St. James. "I think we all believe that electronic charting has got to be the wave of the future," he said.

Thorne said that although it takes a little longer to enter the information into the chart than the old methods, once completed the results are available immediately. "I think it's going to give us better care. I think our charts are going to be better than they were before," added Thorne.

Thorne said the system is user friendly and most people with computer knowledge take to it with relative ease. "It's like learning to use Word or Excel. Once you get used to those programs, you don't know how you lived without them," he said.

With each new patient, the T-System software presents doctors and nurses with a specialized data entry templates on the computer screen. Thorne said that the templates are customized for each diagnosis, ranging from dog bites to chest pain. Templates cue the doctors and nurses with specific questions pertinent to each medical condition.

A left or right click of the mouse and the question is answered with a circle for yes or a backslash for no, said Thorne. There are special spaces for entering results such as X-ray EKG and lab work.

Once data entry is complete, the practitioner pushes a button and a patient report is generated from the entries in text form. And so is a detailed print out of discharge instructions. "We're coming up with much better discharge instructions than we ever have before," said Williams.

Once information is entered, Williams said that the T-System records are automatically electronically archived through a local company called E DOCS. The system has the added benefit of allowing ER personnel to call up patient information for tracking.

"A lot of our statistics were manually entered by our clerks in the front before this," said Williams. Now, results can be sorted in seconds by date of service, diagnosis or even age of the patient seen in the ER.

Williams said that the rest of the hospital is currently not on line but they hoped to see that step taken sometime with in the next five to seven years. In the mean time, patients who are admitted to St. James from the ER have their charts accompany them to the floor. For discharged patients, reports are sent to their health care providers. "In the future we hope to be able to e-mail or fax this report directly to the patient's doctor as well," she said.

Williams said that although health care providers have noticed a drastic change for the better in their patient's chart, the only difference ER patients might notice is that they get a more detailed and legible discharge instruction sheet. "In this electronic world, people are starting to take for granted that things are done electronically," she said.