Hoping to cure mistakes Sutter Health plans to spend $50 million on intensive-care technology August 14th, 2002 By Lisa Rapaport Sutter Health will spend $50 million over the next five years on technology designed to reduce medication errors and improve treatment for patients in intensive care units, company officials announced Tuesday. Grappling with a shortage of critical care specialists and mounting pressure to avoid fatal errors, Sutter and other large hospital chains are increasingly turning to new technology to eliminate mistakes. The embrace of computers to streamline care comes at a time when hospital costs have eclipsed drug outlays as the biggest driver behind rising health insurance premiums. Hospitals now find they must prove that the quality of care they provide justifies the higher payments they have demanded in recent years. "We have been challenged as health care organizations to make significant strides in the area of patient safety. Doing this is good medicine and a sound business move," said Van Johnson, president and chief executive officer for Sutter Health. Over the next 18 months, the Sacramento-based hospital system will open a new electronic intensive-care unit or "e-ICU" near the Sutter General Hospital campus at 28th and L streets where intensive care specialists, or intensivists, will use audio and video technology to monitor critically ill patients at nearby facilities. In concert with hospital staff, these intensive care specialists will recommend treatment and prescribe drugs. "This will be our extra eyes and ears. If one patient goes into heart failure, we have backup to respond and also keep an eye on another patient down the hall," said Diana Moore, an ICU nurse at Sutter General Hospital. At the same time, Sutter will begin training nurses throughout its 26-hospital system to use new bar code technology to ensure that patients get the proper dosage and drug at the right time. Scanning bar codes on patient wristbands, nurse ID badges, and medication containers will trigger a warning at a bedside computer terminal if anything is amiss with medicine before it is dispensed. Such efforts at Sutter and elsewhere have become increasingly common since the late 1990s, when an Institute of Medicine report revealed that, nationwide, roughly 98,000 people a year die from preventable medical errors. Avoidable mistakes are the fifth leading cause of death in the United States -- more than car crashes or breast cancer. And the price is high. Hospitals errors cost between $17 billion and $29 billion a year in unnecessary medical bills, disability payments and lost wages. Employers who purchase health insurance on behalf of most workers in California are loath to accept these numbers, said Peter Lee, president of the Pacific Business Group on Health. "Patient safety is a real issue. And hospitals being accountable for the rising portion of health care dollars they take is also an issue," Lee said. Part of a nationwide coalition of large employers known as the Leapfrog Group, Lee's organization has led statewide efforts to encourage hospitals to improve patient safety. While intensive care specialists can reduce death rates in the ICU, they are in short supply. Nationwide, there are only 6,000 such specialists to serve as many as 8,000 critical care facilities. In California, Sutter's technology outlay will more than double the number of hospitals that have access to intensive care specialists, Lee said. Allen Feezor, health benefits administrator for the 1.2 million member California Public Employees' Retirement System, the largest health care purchaser in the state, called Sutter's technology outlay "a major step forward for California's health care market place" that will offer other hospitals a model to follow in improving patient care. To be sure, Sutter isn't the only Sacramento-area system to use computers to reduce errors and improve care. Local Kaiser hospitals will soon use computerized drug records, eliminating mistakes caused by bad handwriting or sloppy transcription of physician orders. UC Davis Medical Center's telemedicine program has long used computers and audio-visual equipment to link specialists in Sacramento with patients as far afield as Redding, where critical-care physicians are in short supply. Sutter, meanwhile, will hire as many as eight intensive care specialists locally to augment services already provided at Sutter Medical Center, Sacramento, Sutter Roseville Medical Center and Sutter Auburn Faith. Through the e-ICU, intensive care specialists will also start assisting with care at Sutter Davis and many rural facilities that have not had access to these specialists in the past.