As a leader among America's 6,000 hospitals, the University of Pittsburgh Medical Center (UPMC) is undergoing a transformation that is the equivalent of leaping from the 1900s to the 21st century in an eye blink.

If you are lucky enough to live in western Pennsylvania the transformation means improved patient care, fewer medical errors, more accurate prescriptions and, hopefully, less shocking hospital bills.

For the rest of us it is not a matter of "if" our local hospitals will make the same transformation but when. One thing is for certain, it can't be soon enough.

Today, the vast majority of the nation's hospitals follow clinical procedures pretty much as they did 100 years ago. Paper medical records and forms plague them. Physician hand-written treatment orders get lost. Patient charts are not updated or worse, sections are missing or lost. Prescriptions are often illegible. Nurses spend as much time shuffling paper as they do in delivering actual care. These manual processes are worse than inefficient or embarrassing, they can be dangerous.

Studies by the prestigious Institute of Medicine (IOM) castigate our healthcare industry as being the last to adopt modern electronic automation technology. The IOM estimates from 48,000 to as many as 98,000 patients die in U.S. hospitals each year from preventable medical errors. Thousands more suffer illness or injuries while in hospitals that were avoidable. The National Academy of Science says the nation's healthcare system is in a crisis and one step must be more automation and the elimination of paper.

Doing it right

UPMC is a perfect example of how to do it right and a template for hospitals across America to follow. The five-year information technology project involves creating electronic medical records for each of the two million patients treated each year. The records are available to the appropriate clinician whenever and wherever needed. No more lost files or misplaced doctor's orders. Simultaneously, patient privacy is fully protected.

A computerized-clinical information system will link and coordinate every type of medical or patient-care activity, from complex surgery to taking an aspirin. There will be a single "electronic image" for every patient no matter how often or what type of treatment a person receives at any of the more than two dozen hospitals and medical facilities that comprise UPMC.

Eventually, more than 4,000 UPMC physicians will have computerized physician order entry capabilities that eliminate hand-written treatment orders and illegible prescriptions. The UPMC network will track prescriptions to help eliminate adverse drug interactions and ensure the right medicine is given in the right dosage. Intelligent software will be used to advise physicians on medical care options and help them keep track of new pharmaceutical products coming on the market.

The disturbing fact is that relatively few hospitals are attempting what UPMC is doing. The eHealth Initiative, a consortium of more than 120 leading healthcare organizations working to improve quality, safety and cost-effectiveness in our hospitals, estimates less then 20 percent of our hospitals are adopting even basic electronic medical records for patients.

Cultural barriers

With all these benefits, why are so many American hospitals so slow in transforming themselves into e-business on demand institutions? Part of the problem is cultural. Until recently many hospital trustees and executives didn't place a high priority on adopting more electronic automation. Several institutions that tried it had unpleasant experiences because the automation was adopted piecemeal and not in an integrated fashion. Nurses and other caregivers were disappointed in such efforts and complained that this approach actually increased their workload. Any transformation project takes foresight and strong executive leadership to fight against "we've never done it that way before" attitude.

Funding is always a problem with more than half of all hospitals saying they lack adequate financial resources to undertake any significant transformation. In this situation hospitals simply can't do it alone and more aid must come from the federal and state governments and local communities.

What can you do to encourage your local or community hospitals to begin transforming themselves? Some may have already started and if so they need to know you support their efforts. Another step is let your doctor know this is an important issue. Get involved if your local hospital has a citizen or community outreach program. The easiest step is to jump onto your local hospital's Web site and express your encouragement toward their efforts at transformation.

Better hospital patient care and safety isn't just a dream. We know that transformation using information technology can dramatically help our hospitals. We need to show ourselves that projects like UPMC are not just a fluke.