Better medicine without paper

FORT LEWIS, Wash. — Officials at Madigan Army Medical Center, south of Seattle, are in the midst of testing a program for treating Department of Veterans Affairs patients and active and retired military personnel.

Madigan officials are using both the Defense Department's Composite Health Care System (CHCS) and the VA's Veterans Health Information Systems and Technology Architecture (VISTA), said Lt. Col. Keith Salzman, chief of informatics at Madigan. They can access both systems from common

terminals.

Many doctors working at Madigan appreciate the advantages of such widespread access to electronic health records compared with the paper-based practice of medicine common in many hospitals outside DOD and the VA.

Until Capt. Kevin Schlegel, chief of residents and a graduate of Pennsylvania State University, came to Madigan, he practiced medicine in a paper-based environment, he said.

But at Madigan, when he wants to check the record of VA patients, he can instantly find their information in VISTA, including medical histories, lab tests and studies, without digging through

paper files. Access to VISTA and CHCS makes him a more proficient clinician.

Capt. Peter Hennings, an osteopath and resident in internal medicine, agrees. The electronic health care systems at Madigan are "far superior to anything I saw in medical school," Hennings said. He praised VISTA's easy-to-use graphical interface.

The systems also resolve a bane of medicine: poor physician handwriting, Hennings added. Because doctors enter information into CHCS and VISTA with a keyboard, it's "all legible and easily accessible," Hennings said.

Col. George Dydek, the pharmacist who manages the Madigan pharmacy, said access to VISTA can be critical for VA patients in the Madigan emergency room. The system provides information about patients' prescriptions during a 12- to 18-month time period, which can aid diagnosis and treatment.

Salzman said Madigan employees also use data-mining techniques to manage the health of their patient population, which helps minimize hospital visits.