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Ahead of the Curve

by Michael Ybarra

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It could take more than a decade for hospitals to universally adopt electronic medical records. Gundersen Lutheran Hospital is already there. Here's how it led the charge.

In an operating room at Gundersen Lutheran Hospital in La Crosse, Wis., an elderly woman lies on a surgical table draped in a blue sterile cloth with her right foot sticking out. A surgeon threads a wire into the woman's foot to straighten a hammer toe. On the wall, x-rays of the patient's foot are displayed: a side view and a downward shot of her misshapen bones.

For the surgeon, nothing looks much different in the operating room than it did 10 years ago. But during that time, Gundersen's scrappy IT department has managed to sneak technology into virtually every corner of the OR.

The X-rays on the wall are no longer film but high-resolution digital images displayed on black-and-white monitors, part of a picture archiving and communications system (PACS). These images can also be examined anywhere in the hospital or its 38 satellite clinics. On another table sits a computer where the surgeon can pull up electronic medical records (EMRs), check lab results and write electronic prescriptions. Across the room is a secure drug cart with a small computer on top: Authorized users can disperse narcotics like a vending machine after giving a thumbprint, and the system automatically sends orders for restocking. Even the surgical instruments for a procedure are assembled by their bar codes. In the background, a database tracks and certifies the movements of scalpels and clips from sterilization to operating room, thus speeding up the process and reducing mistakes (see "Automation in the OR").

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