Carroll County General Hospital is well on its way to becoming an almost paper-free institution.
A new computer system links many hospital departments, lab tests are ordered and recorded by computer, and soon local doctors will be able to read their patients' hospital records on computers in their offices.
The $2.4 million system, which has been installed over the past three years, has made it possible for doctors to receive medical information on hospital patients and has eliminated many mistakes caused by human error, hospital officials say.
"We call it a hospital-wide system," said Kevin Kelbly, Carroll County General's vice president of finance. "All the financial and clinical information is kept in one . . . data base, and that's a big step forward for us."
The hospital's lab, radiology, pharmacy, dietary and therapy departments are linked by computers.
"A doctor can go to any terminal throughout the hospital and pull up the information on a patient," said Dyana Young, assistant vice president for information services. "A patient may see as many as 10 doctors during a hospital stay, but all the doctors will have access to the same records."
The hospital has an integrated computer system, which means that different departments with different software packages are linked within a host system, Ms. Young said.
Eventually, the hospital will be able to communicate with other health care providers in the area, officials say.
Most larger hospitals in the Baltimore area have integrated computer systems, Mr. Kelbly said, but not necessarily the capability to link with systems outside the institutions.
Carroll County General plans to have complete computerization of medical records by 1999, said Gill Chamblin, hospital spokeswoman.
Some of the most dramatic results of the hospital's move to computerization have been in the laboratory department.
1% "As soon as a lab test is complet
the results are automatically entered in the computer," said Patricia Supik, director of medical, surgical and psychiatric nursing. "That allows us to respond to patients in a quicker and more informed manner."
Before computerization of the lab, technicians would wait until they had completed about 20 tests for patients in the same nursing unit. Then the collected results would be hand-delivered to the unit, and each lab result would be physically attached to a patient's chart, Ms. Supik said.
Based on the results of a lab test, a nurse can now go to a computer, call up a menu and immediately make adjustments to a patient's plan of care.
For example, the nurse can gain access to several categories -- such as diet review, nursing management and pharmacy -- for patients on his or her floor.
Gil Conley, administrative director of the hospital's lab, said computerization of the lab has significantly improved identification of samples and specimens taken from patients.
When a lab test is ordered, the computer prints out bar code labels for each patient, which eliminates most transcription errors.
In addition, the testing instruments record the lab results directly in the computer system.
"We don't want anything handprinted," Ms. Young said.
Once a day, the lab prints a cumulative report of all tests done. The
lists help doctors assess patient progress.
"The doctor can look for trends or responses to therapy based on lab tests that we've done," Mr. Conley said.
Computerization of the lab also has streamlined the hospital's billing process.
"We used to spend a lot of time shuffling paper around to try and get the billing right, and all of that happens automatically now," Mr. Conley said.
Computerization has allowed the hospital pharmacy to integrate its records of intravenous and oral medications, and screen more efficiently for drug interactions and duplications, said Mike Ranke, Carroll County General's director of pharmacy.
"If a patient is taking two different tranquilizers prescribed by two different doctors, it will be detected and prevented," Mr. Ranke said.
The hospital's integrated computer system gives the pharmacy access to a patient's lab results, which can be helpful in monitoring the effectiveness of antibiotics, Mr. Ranke said.
The next phase of the hospital's computerization will be to equip local doctors' offices and train their staffs so they can access their patients' records at Carroll County General. The hospital is testing the system with a few private doctors' offices, and hopes to make it available to all doctors by June, Ms. Young said.
Computerization of the surgical system and operating room also is planned. That will mean a surgical procedure, the equipment used to perform it and its duration will be entered into a computer in the operating room, Ms. Young said.