By Denise Richardson
ONEONTA _ When a patient steps into the emergency department at A.O. Fox Memorial Hospital, a nurse not only assesses injuries but also starts a computer record designed to streamline treatment.
As Fox continues upgrading its information technology, the latest step is a computer beside a patient's bed, accessible to doctors, nurses and physician assistants in the emergency department.
A staff no longer has to keep track of a bulky three-ring binder or decipher hand-written orders or notes, administrators said, and information is accessible to health providers in other areas of the hospital.
``Tracking patient care is much easier this way,'' said Josephine Russo, a registered nurse and project manager for the Horizon Emergency Care computer documentation system.
The system is part of a $7 million investment in information technology and electronic medical records, Fox administrators said. The emergency department is the first department at the hospital to ``go live'' with the system, and some staff have been wearing T-shirts with ``HEC'' lettering to celebrate and promote the upgrade.
The emergency-department upgrade started in April and has been going well, said Alisha Barbera, director of quality management services at Fox.
At Bassett Healthcare, in Cooperstown, Joseph Diver, chief information officer and vice president for information services, said its ``Electronic Health Record'' planning continues, and integrating the emergency department is part of the process.
``In the meantime, our emergency departments and urgent-care centers all are equipped with document imaging, which allows us to scan in records from all affiliate emergency departments and our two urgent-care sites, as well as make the records available for all Bassett providers,'' Diver said. ``We continue to evaluate an overall electronic health-record product for ease of use by providers and nursing staff, as well as compatibility with current software."
At Fox, the first step of a patient's assessment after entering the emergency department is an electronic record started by a nurse. The department has three portable ``computers on wheels'' that doctors and nurses can move into and out of treatment areas and rooms.
After a computer file is created, an image of a body appears and categories of complaints are listed. When a patient is taken into a treatment room with a bed, a nurse will continue recording the patient's medical history into the computer.
Recording data electronically is easier than writing on a chart, said Dr. Gene Pellerin, medical director of the emergency department, and the system provides better documentation with less room for misinterpretation. However, diagnosis still takes time and the expertise of health care providers, he said.
``As good as the computer program is, it doesn't think for you,'' Pellerin said.
The system also can be used to communicate with the pharmacy department, which can expedite prescriptions, staff said. Vital signs, assessment times and laboratory test results also show up on the chart.
``It's already easier to retrieve information,'' said Ed Knuth, a registered nurse, and director of nursing for the emergency department.
Last week, Alyssa Crockett, a sophomore at the State University College at Oneonta, visited the emergency department and underwent laparoscopic appendectomy. She was released Friday and is ``recovering very nicely.
``The computer system was very impressive _ it seemed much easier for the staff and the patient,'' Crockett said in an e-mail Tuesday. ``The staff was amazing and very caring. I had an extremely positive experience at Fox.''
The Fox emergency-department staff includes about 25 nurses, 10 physicians and five midlevel practitioners, such as physician assistants and nurse practitioners, administrators said. When a patient is to be admitted, emergency-room nurses will be able to communicate with nurses in other areas of the hospital more quickly and directly through the computer, they said.
Staff were trained for about five weeks on the system, which also features a tracking board to give a visual report of a patient's status in the emergency department, administrators said. Patients aren't identified by name, staff said. Eventually, an electronic board will be installed in the waiting room to keep families apprised of their relative's location and status.
Meanwhile, a sign in the waiting room says: ``Please be patient and join us as we begin our new, exciting journey to implement the next phase of our computerized medical record.''
