VA Medical Centers lead country in hospital technology   

By Jennifer Lassiter
star staff
jlassiter@starhq.com

  The James H. Quillen Veterans Affairs (VA) Medical Center at Mountain Home in Johnson City provides quality patient care through high-tech computerized technology.
  The VA implemented the Computerized Patient Records System (CPRS) five years ago to track and record all patient data, which eliminated the traditional paper filing system. The old paper filing system still exists for records older than five years.
  The data compiled from the VA medical centers across the country are linked together, allowing doctors from different states to share patient records. Before the system was implemented doctors made phone calls and faxed information, which sometimes could take hours, if not days.
  The CPRS system is in its 23rd version, and is constantly being updated to implement the changing needs of patients and physicians. The CPRS system has eliminated time consuming filing and retrieving, making files more readable and easier to access.
  Dr. David Reagan, Associate Chief of Staff of Ambulatory Care at the VA Medical Center, is the clinical liaison of CPRS at the VA Medical Center. According to Reagan, the traditional method of pulling records and charts takes time away from physicians, which could be spent with patients. The computerized systems allows physicians to pull up all patient information in minutes.
  Physicians at the VA Medical Center log onto the system in their office or in the patient's examining room. With a complex pass code that changes every three months and ensures patient privacy, doctors can view privileged information. All examining rooms are equipped with computers so physicians can access records in the presence of their patient. The CPRS system doesn't affect patient confidentiality.
   Once logged on, physicians can access the CPRS database, which includes a wide variety of information on patients from the time the system was implemented, five years ago, to a patient's last visit. The system even reminds doctors to talk to patients about issues that concern their future health.
  The database allows physicians to gain access to patients' information in a number of ways. Doctors can search the system by name, last visit or illness. Physicians can check appointments, last visit and who placed information in the system.
  Vital signs can be tracked and logged overtime, and with the computerized system, doctors can now view results in easy to read graphs. The graphs, for example, can track a patient's high blood pressure and compare it to normal blood pressure rates. Doctors can not only track blood pressures but all vital signs. The best part of the system, Reagan said is, "You can read it and it's immediately available."
  One of the newest features implemented is the ability to view x-rays and MRI's. Again, the computerized system works instantly. Doctors no longer have to request information from a file clerk. They simply point-and-click.
  Doctors can not only view the films, but the new technology allows a doctor to adjust the density of a chest x-ray to view more of the lungs or the spine, depending on circumstances.
  The data base allows physicians to check appointments, visits and physician notes. Doctors can retrieve information on patient's next of kin, address, phone numbers and insurance companies.
  Prescription orders can be filled with a simple point-and-click. The system works so well that medications already prescribed will flag physicians. The system is also designed to alert physicians to medications that shouldn't be taken together. Doctors still have the ability to override the system if special circumstances exist.
  Through the system, physicians can even track the prescription as to where, when and how often the prescription was filled. Doctors can better track patient compliance issues, rather than just refilling a medication. "The VA leads the nation in preventative care from this system," said Reagan.
   For now, the database system is limited to the U.S. Department of Veteran's Affairs, but a few local physicians and businesses have a vision of implementing a similar system to health care systems in the Tri-Cities area. This would allow doctors to instantly access patient information within the region.
  Reagan is a key player in the group of local physicians and businesses called Community Health Improvement Providers (CHIP). CHIP, with proper funding, could change health care quality in East Tennessee. If implemented, patients would get to choose which physicians or departments, if any, can view their records.
  Information technology like the CPRS system helps develop faster diagnosis treatment options for patients, which saves time and possibly lives. If CHIP succeeds, the Tri-Cities area could be one of a few areas in the nation to have a computerized patient database system.