High-tech health care
A Georgia company is a major player in the push toward using robots and computers to reduce errors by doctors, hospitals and pharmacies.
BY BILL HENDRICK Cox News Service
Nurse Kelly Leroy sweeps a scanner over Richard Handman's bar-coded bracelet like a grocery clerk ringing up a loaf of bread. She's making sure the tiny black lines on his wristband match those on the packet of pills dispensed by Fillmore the cyber-robot downstairs in the Northside Hospital pharmacy in Atlanta.

PHOTO BY PHIL SKINNER / COX NEWS SERVICE Laura O'Connor places pills into a "PAK plus" high-speed packager at Northside Hospital in Atlanta. Drugs are dispensed by a robot into bins with bar codes related to specific patients, then nurses give the medications from special "Care Point-RN" carts.

They do because computers, unlike people, seldom make mistakes.

"It's a great system," said Handman, 72, of Atlanta. "With this equipment, you know they're getting it right."

Prescription errors result in about 2 million adverse drug events a year, including 130,000 that can be life-threatening. Errors are made in as many as 4 percent of the 4.5 million new prescriptions written annually, according to the Healthcare Information and Management Systems Society, an industry trade group.

The nation's $2 trillion health care industry hasn't been keeping up with the times, but a number of companies are going all out to create a safer universal electronic medical system that President Bush says should be in place by 2014.

One of the major players in the burgeoning $40 billion health information technology industry is Alpharetta, Ga.-based McKesson Technology Solutions, which manufactures and sells robots such as Fillmore.

McKesson, which has 2,500 employees, has robots in more than 325 hospitals.

Company President Pamela Pure says health information technology is one of the fastest-growing divisions for San Franciscobased McKesson Corp., a Fortune 18 company. McKesson Technology Solutions accounted for $730 million of McKesson Corp.'s revenues of $24.5 billion in its first fiscal quarter of 2008, which ended June 30, and 23 percent of its operating profits. Its competitors include Siemens, GE Healthcare, Cerner Corp. and Epic Systems.

McKesson Technology Solutions "is really the growth engine that has fueled" the mothership in San Francisco for several years, said Ross Muken, an analyst for Deutsche Bank Securities.

The company's products streamline communication between doctors and patients, build digitized medical records and eliminate pharmaceutical mistakes often caused when pharmacists can't read the chicken-scratch handwriting of physicians.

More hospitals, Pure says, could benefit by buying robots such as Fillmore.

Fillmore lives in a room full of hooks laden with thousands of tiny bar-coded medication bags. On command, it zips down a rail and pulls medicines off, dropping them into an envelope and sending them by computerized pushcart to a nurse's station.

McKesson says its systems monitor more than 95 million drug administrations a year, preventing 325,000 errors a week.

Pure says McKesson's clients include 77 percent of hospitals with more than 200 beds, many major insurance companies and 20 percent of physicians, plus retail pharmacy chains. The division's network stores 1.5 million patient records.

A system called RelayHealth allows doctors to "go online any time, anywhere, to write electronic prescriptions," Pure said.

RelayHealth permits e-consultations with patients, too. They can go to a Web site, log in with a password and fill out a questionnaire. The information allows their doctors to decide whether they should come in for a visit.

Such e-consultations have been assigned a "current procedural terminology" code by the American Medical Association, and thus may be covered by health insurance plans.

But meeting Bush's deadline will be difficult, said Pure and other experts, such as William Custer, director of the Center for Health Services at Georgia State University. Custer says e-medicine is inevitable to reduce soaring health care costs.

Among physicians in Atlanta using McKesson's products is Dr. Shep Dunlevie of the Piedmont Physicians Group.

"You go to the Web site and sign up as a patient," he said. "I get notified a message is waiting for me. It's a great way to communicate. It takes some of the burden off of the phone, prevents phone tag."

"For a charge of $25 or $30, patients can send us a very extensive history, and we can tell whether they need to come in or not," he said. "They put in a credit card before the Web visit."

One patient recently went online from Montana.

The McKesson systems "cut down on back-and-forth chatter with pharmacies," said Dunlevie, who adds he can call up the records of 4,500 patients on a computer.

Patient Jeff Hancock, 34, of Atlanta uses the secure Web site to communicate with Dunlevie.

"You can click on a site if you want a full e-consultation, but you can also send simple e-mails, like if you have some symptoms but don't think you need to come in," Hancock said. "This is particularly beneficial to me because I travel for work."

Dr. Lee Golusinski of Intown Family Practice & Sports Medicine in Atlanta bought a McKesson system that allowed the sole practitioner to digitize the practice's medical records. It's also useful in billing and patient scheduling.

"I've got everything right on the computer," he said. "I can scan in reports from other physicians. It helps track reminders for making sure patients get tetanus shots and colonoscopies. It graphs blood pressure. It alerts me when patients need recalls, and we send them e-mails.

"If you're defining e-medicine as something that helps us do our job better, I think this is long overdue," he said.

Patient Steve Chapman thought he was having a heart attack while running in a triathlon in Kansas and e-mailed Golusinski, who called up his electronic chart and sent him to a cardiologist.

Rich Winston, 46, of Atlanta likes to see Golusinski call up his records in a flash without having to thumb through manila folders.

But there's resistance in the medical community to information technology, mostly because of the cost, says Paul Keckley, executive director of the Deloitte Center for Health Solutions, a research organization.

He also says some doctors fear they'll be open to more lawsuits if they allow e-consultations rather than actually seeing patients in the office.

Prices for RelayHealth and other McKesson products vary widely depending on how much software clients want to include in their systems.

Keckley says some physicians see the move toward e-medicine as merely a "cost-saving mechanism to take money from physicians."

Despite the resistance of physicians and others in health care, the "move to digital has a lot of momentum," Keckley said.

"There will be, I think, an absolute need for this generation of physicians to have technology as a tool," Pure said. "It has to happen to provide good care."

Although most pharmacies already are equipped to handle e-prescriptions, fewer than 30,000 of the more than 900,000 prescribers in the United States do it, according to the Gorman Health Group.

Pure says hospitals and doctors are starting to see that e-medicine is a good investment.

"It seems crazy," Pure said, that only 26 percent of the nation's hospitals have hardware and software like McKesson's at Northside.

The health information technology industry is expanding rapidly, and sales of such hardware and software are expected to hit $5 billion by 2010. McKesson, Pure says, is positioned to grab a big chunk of that.