As nurse Jeremy Copeland chats up patient Wilhelmine Erickson on a recent afternoon at Tacoma’s Allenmore Hospital, he also quickly waves a bar-code reader over her wristband then scans the medication he is giving her.

The action is barely noticeable – seamlessly entwined with Copeland’s questions to Erickson, 85, about how she’s feeling, his flushing of her IV line and handing her a dose of Tylenol.

But the technology at work is significant. Scanning Erickson’s bar code brings up her medical chart on a nearby, portable computer. The electronic system notes that she’s been given the Tylenol – and would alert Copeland if the medication or dose was wrong.

“The computer system can’t replace human beings, but it provides additional safety guards,” said Florence Chang, MultiCare’s chief information officer and senior vice president for clinical support services.

Bedside bar-coding is the last piece of MultiCare’s electronic health records system, which has included a $140 million investment in technology. The bar-coding aims reduce medication errors and improve patient safety.

Allenmore has had the technology since November, and Mary Bridge Children’s Hospital introduced it last month.

Tacoma General will have bedside bar-coding by March, and Good Samaritan Hospital in Puyallup should have it by June, Chang said.

PREVENTING ERRORS

Since 2000, the federal Food and Drug Administration has received more than 95,000 reports of medication errors. These are considered preventable events that led to patient harm or misuse of medicine, according to the agency’s Web site.

Because the reports are voluntary, the number of actual medication errors is believed to be higher, the FDA reports. They can happen for a range of reasons, from poor handwriting on drug orders to confusion of drugs with similar names to bad packaging design.

Bedside bar-coding – when done well – is one way to help keep medication errors down.

A scan to a patient’s wristband pulls up a chart on the computer listing the patient’s medications, when they should be taken and the amount.

Once the medication is scanned, then the system will warn a caregiver if a physician has ordered the drug to be discontinued or whether there are any bad interactions with other medications the patient is taking.

“It’s a good system – way past due,” said Jennifer Spotted Horse, a clinical nurse specialist at Allenmore.

And there are already signs that it’s working.

INTELLIGENCE REQUIRED

Chang said that last week, an Allenmore nurse delivered two medications to a patient and received a warning alert as she scanned the drugs into the system. The patient’s doctor had just changed the prescription to a different dose – and an alert popped up to tell the nurse so.

Still, the system is only as good as the humans operating it.

“From the very beginning, I’ve been saying ‘garbage in, garbage out,’ ” Chang said. “You still have to have correct information and it still requires human intelligence and human thinking into the system.”

To that end, caregivers still ask patients simple questions to verify their name and birthday, and they double-check information coming from the computer.

THE BIGGER PICTURE

The medical industry has been slow to adopt technology for a host of reasons from the high cost to the sheer complexity of transferring all that hospitals and health clinics do from paper to computer.

But recent federal incentives – combined with some potential penalties – are prompting more to change.

“We are certainly moving forward in the industry like we have never moved before,” said David Collins, the director of health information systems for the Health Information and Management System Society.

HIMSS represents thousands of health care organizations and is focused on providing leadership for use of information technology in health care.

Collins called MultiCare a leader in the industry, noting that HIMSS awarded the health system its Davies Award in September for excellence in implementing and gleaning value from its health-information technology.

MultiCare was the only organization to receive the award for 2009.

MultiCare’s complete electronic health record system has been more than a decade in the making. It includes physician order entry – the ability for doctors to enter their orders electronically onto a patient’s chart; electronic image sharing between caregivers and locations; and an online health record patients can access themselves.

“Now our electronic health records systems runs all the way from administration to the emergency department and the (operating room), to patient records and billing,” Chang said.

SHARING INFORMATION

Franciscan Health System, which operates five local hospitals and numerous clinics in Pierce and King counties, also has been improving its use of technology over the past decade – and looking for ways to do more.

The health care organization developed its Franciscan Health Information Exchange in which physicians inside and out of Franciscan can electronically access patients’ health information.

Franciscan has already introduced electronic prescription writing for the physicians in its clinics and plans to roll out the technology – along with bedside bar-coding – to its hospitals over the next two years, said Mary Kasal, Franciscan’s executive director of information technology.

The health system is also exploring ways for patients to access their health records online using programs they are familiar with such as Microsoft and Google.

ADDED BENEFITS

Collins, with HIMSS, said organizations who keep patients – and the safety and quality of their care – at the top of mind as their reason for adopting more technology are most likely to succeed.

“The patient should be the reason why this is done,” he said. “But of course health care is a business – and even if you do it for the right reasons, you still have to make money.”

That electronic health record systems often provide financial and operational benefits certainly helps organizations step up to the high cost of starting them.

Spotted Horse, the nurse clinician, said that Allenmore nurses were a little leery of the bedside bar-coding at first, but that it’s been well received.

“What we didn’t expect was that it would take less time,” she said. “There’s just less running around.”

At MultiCare, Chang said the electronic health records system – with all of its pieces working together – has helped improve the hospitals’ operating margins, reduced the length of stay for patients and eliminated duplications and redundancies in the system.

One example: MultiCare decreased its need for medical transcriptionists by a third after its doctors and nurses switched in 2008 to documenting orders and prescriptions electronically instead of on paper.

Chang said that the financial benefits from the complete electronic health records system means MultiCare will break even on its investment by 2013.

PATIENT REACTION

The technology also will provide data that reveal trends on everything from patient reactions to medication to infections, Chang said.

Many MultiCare patients seemed to have welcomed the advances. Chang said that partly because people now are more comfortable with technology.

And they can see its benefits, from being able to electronically access their own health records to not having to repeat health history to each different doctor.

Copeland’s patient Erickson, at 85, was unphased by the bedside bar-coding.

“It’s the modern thing,” she said. “It’s just technology – I’m old enough to have come through a lot of it.”

Kelly Kearsley: 253-597-8573

Kelly.kearsley@thenewstribune.com