By Nancy E. Oates

The baby is on its way; the soon-to-be mother is en route to the delivery room; and her paper chart is where?

It’s hours before dawn on a weekend, and no one is at the obstetrician’s office to fax over a replacement. The doctor on call will go into this delivery with no information about the mother’s pregnancy.

Scenes like this are history for two Duke practices whose doctors share call. In 2008, Harris & Smith OB-GYN and Durham Obstetrics and Gynecology converted to DigiChart, an electronic medical records system that gives health care providers instant online access to a patient’s medical chart.

Charles O. Harris, MD, of Harris & Smith credits digiChart with saving time and money, as well as improving patient care. “I have access to my patients’ medical records around the clock, at the hospital or from my home,” Harris says. “We can spend more time with patients instead of tracking their charts.”

DigiChart uses the American Congress of Obstetricians and Gynecologists antepartum record that is familiar to doctors. They don’t have to learn a new charting system, says Sue Powell, practice manager for Harris & Smith.

Patients can fill in their medical history from home over a HIPAA-compliant Internet application, or someone in the practice can walk them through the process on one of the waiting room computers before an appointment.

DigiChart, which asks for no Social Security numbers or credit card information, has been fully vetted by Duke’s Division of Clinical Informatics and is certified by CCHIT (Certification Commission for Health Information Technology).

“DigiChart is more secure than a paper chart,” Powell says.

The problem of where to store thousands of paper charts and the delay in retrieving charts stored off-site prompted the two busy practices to explore an electronic medical record system.

Converting to DigiChart makes life easier for patients, too. Each practice has two locations, and when a patient shows up at the wrong location for an appointment, staff can access her chart electronically, and she can be seen by a physician at either office.

Staff can program prompts into DigiChart to be notified if a lab report has not come back when expected or the patient has not followed through with a mammogram or other test. DigiChart sends a “to do” list to physicians and flags calls that must be returned immediately.

All calls are time-stamped to better document when they came in and how quickly they are returned. Physicians can delegate tasks to staff electronically and transmit prescriptions and order lab work directly.

By documenting clinical notes into the chart themselves, doctors eliminate medical transcription costs. Once the doctor signs off on the chart, the information can’t be changed, even though two users can be logged into the chart at the same time.

Any lab data electronically received must match four identifiers for each patient or it populates an exceptions report. This allows the correct patient to be identified before the results are entered in the patient’s chart, says Debbie Loflin, health information management supervisor for Durham OB-GYN.

A photo of the patient is scanned into each chart, corroborating that the doctor has the right chart when seeing a patient; the photo also appears in the appointment log, providing extra protection against stolen insurance subscriber numbers.

“Moving to an electronic medical record takes a significant amount of time and effort from both the practice and the information technology team,” says Powell.

“We’ve had to collaborate and communicate as we brought the technologies together to ensure that the product works in the best way for our staff and our patients. It’s been very rewarding to see how the new system is improving the safety and experience of our patients.”

“It all helps patient care,” Loflin agrees.