VA Takes the Lead in Paperless Care

Computerized Medical Records Promise Lower Costs and Better Treatment

By David Brown

Washington Post Staff Writer
Tuesday, April 10, 2007; Page HE01

Divya Shroff, a staff physician at the Veterans Affairs Medical Center in Northwest Washington, stops what she’s doing to answer her phone: It’s a doctor down the hall who needs help with a man struggling to breathe.

She calls up the patient’s medical record on the computer at her desk and scrolls through lab reports, doctors’ notes, X-rays and EKGs, thinking out loud with the medical resident, who is at the man’s bedside.

Strep pneumo in the blood. Chest film looks like he’s accumulating fluid. Supposed to get a chest tube. Hard to wake up. No new meds that would be sedating him. Looks like he needs the ICU.

Over the next 10 minutes, Shroff visits the patient’s room and the ICU, and in both places summons his medical record on other computers while she talks with a half-dozen people about what needs to be done. She spends no time looking for the patient’s chart, riffling through paper or decoding handwriting. Nor does she ask anyone to take her word for things. She just lets the evidence — all of it right there for everyone to see — make the case that the patient needs to be moved as soon as possible.

It turns out to be the right decision. Soon after he gets to the ICU, he stops breathing. Doctors resuscitate him and put him on a ventilator.

Did the electronic medical record save this 71-year-old man? It’s impossible to say

But this much is clear: Never again will a VA patient’s chart be an excuse for things not happening efficiently. Never again will information that is lost, hard to read or impossible to move from one place to another be a factor in the complicated calculus of what makes good medical care — and, on occasion, saves lives.

The electronic medical record is the most important single development helping to usher in the Era of No Excuses in modern medicine.

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