Computerized Records Surmount A Medical Emergency.

Business Editors/Health/Medical Writers

ROHNERT PARK, Calif.--(BUSINESS WIRE)--Jan. 12, 2004

Physicians treating diabetics will never forget the day when the FDA suddenly and without warning ordered Rezulin off the market. The powerful and widely used drug, it turned out, could cause severe liver toxicity and in some cases irreversible liver failure.

The announcement, in March 2000, sent doctors across the United States urgently searching their files to locate patients who, all unknown to themselves, were at high and unforeseen risk.

For some it was a nightmare, plowing through a mass of papers put in at different times, updated here, amended there.

But for Jack Devine DO, an internist in Lewisburg, Pennsylvania, the search took four minutes. Within a couple of hours his staff had called all sixty patients who were on the drug. Within three or four days he had seen virtually all of them and prescribed alternative medications.

"It made me feel that this is what doctoring is all about: protecting people who rely on me from serious harm," he says.

He could only do it, however, because six years ago he had completely computerized his patients' records. "Without that, we would have been riffling through nearly two thousand files for days and never certain in the end that we had found everyone".

Patients were quick to express their appreciation. "When you do something like that, people talk about it," Devine comments. With the bulk of new patients coming to him through word of mouth, the value to his practice as a business is clear.

At a time when practices all over the United States are fighting the twin pressures of rising costs and tighter regulation of fees, the choice may not be merely between degrees of doctoring but any doctoring at all.

"If I hadn't computerized the records, I'd have needed two full-time assistants. In this area that's over $54,000 a year in pay and benefits. I don't think my practice could have survived," Devine says.

Pennsylvania is one of a growing number of states in a malpractice crisis. The insurance Devine paid $5,000 a year for three years ago would now cost more than $20,000. "Even in our local area, three or four practices have closed, as have droves of others in the state as a whole," he says.

Devine went to electronic records only after a lot of thought. Until 1996 he had never owned a computer, either at home or in the office. Like most newcomers the feature he looked for above all was ease of operation.

What he particularly liked in the system he finally chose -- ChartWare -- was how simply he could adapt it to his own specialty and personal way of working. "All the clinical terms I need are in there or can easily be added. As documentation requirements have increased, it has helped relieve me of repetitive time-consuming chores, while not interfering with the patient care methods I've built up for myself over the years".

He installed the new system in early 1997. By July of that year, and with the help of ChartWare staff, 95 percent of his notes were computerized. Before long that went up to 100 percent and all of them at the point of care.

By the time the patient walks out of his office, he says, the note is ready. "I make the note during the office visit so I don't forget something or, in the future, have to wonder what I meant by a hard-to-read handwritten note."

As for coping with complicated cases, Devine is emphatic. "I have never found anything I wanted to do with record keeping that I couldn't do with ChartWare," he says.