Goodbye illegible physician's scrawl. Hello computer font.
Jokes about doctors and bad handwriting have persisted for decades, but they may soon be a thing of the past at Parkridge Health System.
The three-campus system is the first in Chattanooga to switch to a computerized system that eliminates paper charts for patients. Instead, doctors use computers on wheels or at nursing stations to document their notes and doctors' orders.
"This is our first step in going completely paperless," said Jerri Underwood, market chief nurse executive at Parkridge. "Doctors don't have to wait for charts or find charts to enter their information. It all updates automatically."
The hospital tested the system with a soft launch for about a month before going live on all three campuses -- Parkridge, Parkridge East and Parkridge Valley -- this week.
On Tuesday, the "war room" at the main campus buzzed with activity as more than a dozen people hunched over laptops. Some of them helped train doctors while others made sure the system hummed smoothly throughout the day.
Parkridge is owned by Hospital Corporation of America, and doctors from other HCA hospitals that already have launched their own systems were on hand to help troubleshoot and train doctors. About 40 HCA hospitals out of more than 160 are in the process of launching the program, with others expected to switch to the system soon.
Since this is not the first time HCA has used the system, the launch at Parkridge was mostly trouble-free, said Dr. Justin Collier from TriStar Health in Brentwood, one of the physicians helping Tuesday.
"The changes are always happening in real time; we are continually optimizing the process," Collier said.
The two other Chattanooga hospitals, Erlanger Health System and Memorial Healthcare System, use some electronic documentation, with most nurses and other staff using electronic entry.
Memorial spokeswoman Sonia Moss said the hospital hopes to have its physician order entry fully operational in about a year.
At Erlanger, trauma specialists are using a pilot program to test physician electronic documentation, according to Laurene Vamprine, the hospital's chief information officer, but there is no specific time frame to implement the system hospitalwide.
Dr. Naveed Memon, a hospitalist at Parkridge who has been one of the physicians working on the ground to get everything ready to launch the new system, said most physicians have welcomed the change. They will not be required to use it immediately but are encouraged to do so as soon as possible.
A physician order entry system has huge benefits, including improving patient safety, efficiency and streamlined care across all campuses, doctors at Parkridge said.
As doctors enter orders, they immediately update on a huge flatscreen monitor at each nurse's station. The monitor identifies each patient by initials -- which makes it compliant with federal HIPPA non-identification laws -- and shows medications, orders and tests being done for the patient. An order for a lab test goes straight to the lab and a prescription pops up at the pharmacy. If an order needs to be completed immediately, a blue light flashes on the screen.
Although doctors enter all their own orders and notes in the new system, much of it is preprogrammed so they can simply click boxes or choose orders. If they begin to write an order or prescription, choices pop up and allow them to choose the correct one.
And this is where the curse of bad handwriting goes away -- prescriptions are far more likely to be correctly filled if a doctor enters them on a computer rather than on a chart, Parkridge officials said.
"This speaks to our commitment to patient safety," Memon said.
The system also uses preprogrammed sets for specific illnesses. For example, when a patient is diagnosed with pneumonia, the doctor chooses that set and the medication, lab work and other treatments for pneumonia are immediately launched. A doctor can override or change the order if he decides to, but it makes him or her aware of what is considered the best evidence-based treatment.
With computers on wheels that can be rotated and moved to many different positions, doctors can take them into a patient's room and sit down to write orders. They also can access a patient's chart from any hospital campus or from their mobile devices, giving them the latest information and a complete patient history.
Eventually, the goal is to share that information across hospital systems, Collier said.
Right now, that is not possible because not all hospitals use the system. And even if hospitals do use electronic documentation, they may use different programs.
"It is definitely needed, but this is an important step in that direction," Collier said.