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    Backstage at the Medical Revolution

    Behind-the-scenes technologies are transforming medicine -- but who's gonna pay?

    Barring Drug Errors continued...

    The system, which is already in use in several hospitals throughout the country, works like this:

    When John Q. Patient is admitted to the hospital, he is given a bar-coded ID bracelet that links him directly to his computerized medical record. Before Nurse Nancy gives him a drug, she scans the bracelet, which calls up John's medical record, and then scans the code on the drug package. The information is whisked electronically to the hospital pharmacy, and the computer whirs into action, comparing the drug, dose, and time of administration with the prescription information already on file. If there's a discrepancy, such as the wrong drug, wrong dose, or a change in the patient's chart, the computer sends an error message to Nancy, who looks for the source of the problem.

    The FDA estimates that uniform adoption of the barcode system will result in a 50% increase in the chance that a drug error will be caught before the drug is administered, leading to a drop in "adverse" drug events of more than 400,000 over the next two decades.

    In addition to saving lives and preventing drug-related health problems (and the lawsuits that inevitably follow), a barcode system offers benefits that would warm the cockles of any managed-care Scrooge's heart, including greater health-care-worker efficiency, more accurate billing, inventory control, and reduced malpractice insurance premiums.

    For the Record

    Another innovation that's found a niche in a few leading hospitals -- such as Boston's Beth Israel Deaconess Medical Center -- is the online medical record. The OMR, as initial-loving doctors call it, is an electronic version of the old paper folders bulging with notes, lab test results, copies of prescription orders, letters between doctors and patients, referral slips, etc.

    Paper records take up warehouses full of space, they weigh a ton, they take a lot of time to duplicate, and they need to be shipped from one place to another whenever a patient switches doctors or sees a specialist.

    But imagine if every time you went to a new doctor, all you had to do was give him or her a password granting access to all of your medical records instantaneously.

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