Denver Health offers a prime example of how technology can heal America’s ailing health-care system. The community health-care network, with a 500-bed hospital and nine family-health centers in Denver’s lower-income neighborhoods, doesn’t turn anyone away. More than 40 percent of its patients don’t have insurance and can’t pay for their care, which cost the institution $280 million last year alone. The hospital has responded to that challenge over the last decade by embracing efficiency-improving, high-tech systems, like electronic medical records and billing systems. Since 1997 it has spent $259 million (out of a $420 million annual operating budget) on IT, putting a computer in each office and treatment room, so doctors and nurses can see a patient’s lifetime medical history and get quick access to medical references. Such widespread computerized care places Denver Health on the front lines of America’s drive to drag health care into the high-tech age. “Once you get over the learning curve, it’s a timesaver and an opportunity to engage the patient much more,” says Dr. Andrew Steele, the hospital’s director of medical informatics. “I feel like I’m providing better care.”
Like many public-health institutions in the ’90s, Denver Health was on rocky financial footing. Longtime Denver Health physician Patricia Gabow took over as CEO in 1992, and though she describes herself as computer illiterate, she recognized that a prescription of high technology might be just what the doctor ordered. The hospital instituted a billing system that automatically checked state records to see if a patient had Medicaid or private insurance, which instantly saved millions annually, and it began scanning paper medical records and making them available on hospital computers.
Inspired by early success, the hospital got more ambitious. In 1999 it was one of the first hospitals to buy, from German technology company Siemens, a system called Lifetime Clinical Records, which provides online access to all the details of a patient’s checkups and treatment in the Denver Health system. Three years later the hospital began cautiously rolling out Computerized Physician Order Entry (CPOE), which put computers in each treatment room and turned them into the nexus of patient care. Instead of scribbling illegibly onto a notepad, docs typed prescriptions and treatment orders directly into the computer. For ailments like diabetic ketoacidosis, they also created standard protocols so nurses or residents could treat patients quickly and efficiently.
Other health-care institutions have rejected or postponed such changes, often because doctors don’t have the time to invest in learning the new technology. Denver Health overcame bureaucratic obstacles by appointing a high-ranking doctor or nurse as “clinician champion” in each department, in charge of cracking the whip. The hospital also moved slowly; it introduced CPOE to the intensive-care unit and worked to perfect the system there for 18 months before moving it to surgery and, more recently, to the rest of the hospital and its clinics.
Doctors at other hospitals also tend to resist what’s called “cookbook-style medicine,” complaining that computer-provided care regimens reduce their control over patients. But at Denver Health, the physicians are all proud chefs. “Cookbooks work because recipes in them have been modified and altered over time, so the result comes out the way it’s supposed to,” says Albert. “In fact, it frees us from trying to be memory machines and gives us more time to think and be with patients.” If you’re a patient, that’s a meal you’ll enjoy any time.
