Inland Northwest Health Services plans to hire 70 well-paid computer-technology and health-care analysts this year and next as it upgrades its electronic regional health-care information network.


The workers, who will earn between $60,000 and $75,000 a year plus benefits, will help the nonprofit hospital collaborative expand its burgeoning network, says Fred Galusha, INHSs chief information officer.


We are experiencing at least a 30 percent growth this year, with similar growth expected next year, Galusha says.


Jon Eliassen, president and CEO of the Spokane Area Economic Development Council, calls the expansion great for Spokane, because while they can expand their network regionally and even elsewhere, it grows jobs for Spokane. Linking medical and computer technology, as INHS does, is an example of the kinds of places Spokane can grow its economy in the future, Eliassen says.


INHS has reaped numerous accolades for the convenience and geographic reach of its network, which now links 31 hospitals in the Inland Northwest and one on Washingtons West Side. Its electronic-information arm already employs 150 peopleat salaries that average more than $60,000 a yearon the fourth and fifth floors of the Holley-Mason Building, at 157 S. Howard downtown.


The plan today is to expand onto the third floor at the Holley-Mason to handle our growth this year and next, Galusha says.


That growth is being driven by an upgrade and customization of the information the INHS system feeds into practitioners handheld personal computers, which link with hospitals in the system to download laboratory test results, pharmacy reports, and radiology files, Galusha says.


This week, INHS is launching a new system through which it will customize further the displays of information that physicians receive on their handhelds.


Theres a difference in the display for an intensive-care specialist and for a surgical-medical specialist, he says.


How information is customized will depend on a physicians medical specialty and own desires. For example, alerts will appear automatically, in the form of different-colored bands, when a patients vital-signs, test results, or the like fall outside boundaries a doctor has set.


The customization work will be labor intensive, causing INHS to do the heavy hiring it projects, and comes after a two-year upgrade of the systems communications capabilities and the computer infrastructure systems at hospitals, which record lab, radiology, and pharmacy data, Galusha says.


Some 50 of the 150 people on INHSs information-technology staff serve in support roles, and their numbers wont change much, he says. The other 100, however, fall into two categories: those with backgrounds in computer science, informatics, or medical informatics, and those with clinical experience as nurses, pharmacists, radiology technicians, or in other fields. (The Indiana University School of Informatics defines informatics as understanding the impact technology has on people, development of new uses for technology, and the application of information technology in another field.)


INHS expects to add about 30 people to those two groups this year, bringing their numbers to about 130, then add about another 40 people next year, for a total of about 70 new hires over two years, Galusha says. He says INHSs network provides valuable financial and management information to its member hospitals, but its growth now is occurring in health-care practitioners use of the network.


Fifty-five percent of the physicians who have access to the network use it, which is unbelievable, Galusha says. This is actual use. This is not just folks who have an ID and a password.


Some 550 physicians are making patient-care inquiries and accessing electronic medical records on the network, and so are 3,000 nurses and many pharmacists, Galusha says.


Last month, the doctors who use the network, basically those who have staff privileges at the hospitals in the network, made 56,000 inquiries for clinical information, or more than three times as many inquiries as in March 2002, Galusha says.


I think were seeing a tremendous acceptance of technology by physicians, he says.


Using the electronic network reduces paperwork costs for hospitals, which underwrite the cost of the network, and enables practitioners to save time, Galusha says. An INHS study found that with paper-based medical record keeping, nurses typically spend 1 1/2 to 2 hours a day hand-writing notes, but spend only about 30 minutes a day writing notes when they work with the electronic system.


Most doctors have about a dozen patients in the hospital at any one time, and patients charts average roughly 80 pages, so a doctor might sheaf through 960 pages of paper if he or she were to look at or make notes on the charts of 12 hospitalized patients a day, Galusha says.


Before doctors who use INHSs system do their daily rounds at hospitals, they download into their handheld computers updated electronic versions of their patients charts, he says. The readings on the electronic charts are legible, the time they were entered is recorded precisely, and a doctor can compare a patients most recent vital signs or test results with earlier reports pulled from the hospitals in INHSs network, Galusha says. That can help a doctor look quickly for trends in a patients health and avoid ordering tests that already might have been done, he says.


For ease of use, readings, test results, and other information are displayed side by side on the screen of a physicians handheld computer. The system also puts into practitioners handhelds standard clinical information about maladies.


Working at a personal computer in a patients room, a doctor or nurse updates a patients chart information and makes needed notes while seeing the patient. When its been put into the system, its immediately available, its secure, its accurate, Galusha says.


Through voice-recognition technology, doctors who are in other locations often can gain access to the electronic X-ray files of their patients in 2 to 15 minutes, along with the final report of the radiologist who had read the file, Galusha says. He says that compares with the two to 15 hours it can take when a physician must call to have a film X-ray pulled, retrieve it or have it transported to their office, perhaps have that set of film and a fresh set read by a radiologist, and consult with the radiologist afterwards.


Rapid availability of X-rays through an electronic system can improve and speed patient care, Galusha says. INHSs electronic network allows doctors working at a computer workstation to take a closer look at an X-ray by changing the contrast of part of the image or to scroll through the slices of a magnetic resonance imaging, or MRI, file, which is taken in numerous cross-sectional views.


The network also can reduce paperwork burdens at practitioners offices, Galusha says. He says that before one doctors group began using the network, it typically received 300 to 400 pages of new chart information in the mail from hospitals each day, and kept three to four staff members busy scanning in those pages. That group now receives new chart information electronically, and one staff member handles each days incoming reports.


Over the electronic network, doctors can access patient files from their offices or homes, eliminating the need to drive to the hospital or to their offices to see results, Galusha says. Because the system is electronic, an attending physician can consult with a specialist in another location while both view the same data on their respective computer screens.


Theres no charge to the physician for any connectivity, Galusha says. The hospitals are our sponsors.


The annual budget of INHSs information resource management department, almost all of which applies to the network in one way or another, is $18 million. The hospitals are willing to bear such an expense because they can either mail thousands of pages of chart information to doctors offices each day or we link them up securely and transmit those pages electronically, Galusha says.


Electronic storage of information also can save money. For example, Galusha says it costs $17 to file, store, and manage a single set of X-rays during the life of the films. With electronic X-ray files, the cost is nearly 30 percent less, he says.


Hospitals that use the INHS system spend about 1 percent less on information technology than the national average, but usage of their information is much higherat least 25 percent more in terms of clinical applications than the average hospital, he says.


The system has achieved such high usage because INHS is a collaborative organization, Galusha says. It was formed by Providence Services Eastern Washington, which owns Sacred Heart Medical Center and Holy Family Hospital, and Empire Health Services, which owns Deaconess Medical Center and Valley Hospital & Medical Center, to handle collaborative ventures, such as St. Lukes Rehabilitation Institute and the MedStar helicopter-ambulance service, both of which are located here. In most cities, competing hospital systems havent formed joint electronic-information systems, he says.


Among competing integrated health-care delivery systems, we probably have the highest degree of integration of systems in the United States, Galusha says. Where he worked previously, in Orlando, Fla., the four hospital systems had four separate information systems.


Also this year, INHS plans to implement a new computerized tracking system in the emergency departments at the four Spokane-area hospitals and Coeur dAlenes Kootenai Medical Center, he says. He adds that the system should allow triage care to be given more rapidly and efficiently at the five hospitals.


By the end of 2005, INHS hopes to have rolled out at all Spokane-area hospitals a bar-code system that tracks patients prescriptions, dosages, and the times their medications are to be given and verifies that theyve been given. Sacred Heart has that technology now.