When a 34-year-old man showed up in the emergency room at UPMC St. Margaret complaining of excruciating lower back pain and asking for painkillers, the attending physician looked up the man's records on a portable computer.
The device gave Dr. Timothy VanFleet instant access to the man's complete medical records, including a visit three days before to a doctor's office, where he was prescribed 60 tablets of Percocet, a powerful narcotic.
"Years ago, we would have never been able to see what someone was prescribed in a doctor's office," said VanFleet, who also is director of emergency medicine at Magee-Womens Hospital in Oakland. "There was a big separation between the hospital and doctors' offices."
If VanFleet was able to stop the man's attempt to get drugs, it's because of the latest incarnation of the medical record -- an emerging technology that has allowed doctors to replace scribbled paper records with slick, electronic versions.
The sharing of electronic medical records among hospitals and doctors' offices is perhaps the most eagerly awaited development since doctors started using computers to prescribe drugs.
At the University of Pittsburgh Medical Center, a doctor in Oakland can view a CT scan taken miles away in Bedford. And an emergency room doctor can look at charts of an unconscious patient who has been treated before at UPMC.
"It's just making it easier for people at the hospitals to do the right thing," said Dr. Dan Martich, a critical care doctor turned computer guru who is overseeing UPMC's electronic medical record initiative at a cost of about $225 million a year. That includes an $84 million partnership with a company called dbMotion that is linking UPMC's inpatient and outpatient computer records.
"It's a young field, it's a very young field. We're helping define it, frankly, at UPMC," Martich said.
UPMC's goal is to enable computers at its 19 hospitals to talk with computers at the network's 400 outpatient sites. It could be three years before everyone is connected.
If giants such as UPMC are ahead of the game, the rest of the nation has a lot of catching up to do.
A national survey published last month in The New England Journal of Medicine found that fewer than one in five doctors in the United States are using electronic records.
The survey of 2,758 doctors found only 4 percent of doctors nationwide reported having a fully functional system. Another 13 percent said they had a basic electronic medical record system.
The biggest barrier is cost, said lead author Catherine DesRoches of the Massachusetts General Hospital's Institute for Health Policy in Boston.
"There's a lot of uncertainty about the return they would get on that investment," DesRoches said.
Doctors also question their ability to select, install and implement a system that meets their needs, she said.
But there is consensus that electronic medical records help improve quality of care, DesRoches said. …