Web-based applications are steadily changing the way medical services are being delivered, incurring massive savings for service providers and significantly reducing the overall error rate among medical personnel, says Henry Adams, SA country manager for US-based database system developer, InterSystems.
"As a single example, the adoption of Web-based applications in only one section of a major medical services institution in the US has caused up to a 90% drop in the number of medical errors in that wing and has significantly reduced overall operating costs for that institution," says Adams.
The 90% improvement rate was achieved on one floor of the Beth Israel Deaconess Medical Centre in Boston, after it adopted a Web-based application, built upon InterSystems` Cach'e database technology, to improve patient care.
"Errors were obviated in a wide range of day-to-day activities, from unreadable prescriptions to drug dosage mistakes," says Adams. "When you consider that more people in the US die from medical errors in hospitals than from highway accidents, breast cancer or AIDS, the magnitude of the problem can begin to be grasped."
This error statistic - revealed in a study released by the Washington-based Institute of Medicine - occurs in a country with one of the most developed healthcare systems in the world. "What of SA, with its emerging market profile?" Adams asks. "Addressing the problem here in a similar manner must be the only way forward.
"Their first target was an outdated and error-prone process used by physicians to order prescriptions," continues Adams. As at most US hospitals, doctors wrote prescriptions by hand and faxed or delivered copies of them to pharmacists.
In June last year, the hospital replaced that with a Web-based system that not only allows doctors to place prescription orders online but also connects to electronic patient medical records. "In this way, it can alert physicians to possible drug reactions or past allergies," says Adams. "It also reduces errors caused by hard-to-read handwritten prescriptions. After all, the difference between 0.5mg and 5mg of a medication can kill a patient."
This was but one application; later on in the year, the Beth Israel Deaconess Medical Centre streamlined the process used for tracking patient status in emergency rooms. The hospital replaced a physical whiteboard with a 1.2 metre-wide electronic screen, displayed inside the emergency room and accessible by doctors through the Web and over a wireless LAN.
"This electronic dashboard has reduced the average patient`s time in the emergency room by half an hour, giving doctors and staff up-to-the-minute information on things such as patient lab tests," Adams says.
This benefits the patient, and also relieves workload stress on the personnel. Equally importantly, it reduces overall operating costs where critical care expenses are calculated by the minute.
At Beth Israel Deaconess Medical Centre, patient records are stored on InterSystems` Cach'e database running on a Unix server. Financial records are on a Microsoft SQL Server 2000 database server.
As with the prescription systems, doctors and nurses can access the electronic dashboard through the Web on a PC, or through their own handheld devices. "The dashboard provides a snapshot of who`s in the emergency room, and also delivers immediate updates when lab results and x-rays are available or when a bed becomes available," Adams says.
"Compare this to the old process, where staff would physically have to update a whiteboard every hour or so causing backlogs and confusion.
"Web applications are revolutionising the way that healthcare is dispensed," concludes Adams. "If South African hospitals are to improve service delivery while containing costs, it will be vital for them to move onto Web-based systems which are proving to be so successful all over the world."
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