When Dr. Tom Schaaf began fielding questions from family members of a patient he visited at Sacred Heart Medical Center recently, his answers were coming a little easier than usual.


It was Schaafs first day doing his rounds using a hand-held computer that contained up-to-date information about the patients care while in the hospital. The electronic charts, from lab and radiology results to diagnostic reports from consulting physicians to a list of the medications the patient was receiving, were all there, quickly accessible with the tap or two of a plastic stylus.


It was great, says Schaaf, who is clinical director here for Group Health Permanente. Every thing they asked me, I had the answer, right here, he says, holding up his Sony Clie palm-sized computer.


In the past, Schaaf says, he would have thumbed through 40 pages of stuff to find the answers to such questions. Or he would have had to walk to a nursing station to log into a computer that uses a cumbersome program to display patient information. He figures the hand-held device shaved 30 minutes off his 11-hour workday that first day, and gave him more time to provide patient care.


Schaaf was participating in a two-week pilot project he helped design in conjunction with Inland Northwest Health Services (INHS), a collaboration of Spokanes major hospitals that, among other things, ties together the computer systems of 26 hospitals in the region.


Craig Nielsen, chief application architect at INHS, says the project takes advantage of the fact that those hospitals all use the same comprehensive medical software suite, called Meditech, into which they continuously enter all their patient databoth clinical and billing. That means whenever a lab test is performed or radiology exam is done or drug is administered, the results of those procedures are typed into a module of that software. Medical personnel can access that data on standard PCs located at nursing stations throughout a hospital, supplementing the hard-copy charts that also still are used.


Now, says Nielsen, that information also is available on a Palm Pilot-like device, so doctors can take it with them.


What the doc has is mobility of the most-recent reports, be they consults, radiology, labs, or meds, he says.


Thats made possible with a technology developed by a company called Mercury MD Inc., of Durham, N.C., which converts the data in the Meditech system for use on hand-held computers. The data a specific physician needs to serve his or her patients is downloaded into a hand-held using an infrared beam at a docking station.


Sacred Heart has set up four such docking stations, each of which can accommodate four hand-held computers at a time. The process takes just two or three minutes.


To meet federal patient-privacy rules, a doctors hand-held computer must log into the Mercury MD using a secure username and password. Based on that information, the system downloads information only on the patients that doctor is attending. For Schaaf, that was 21 patients the day he first tried the system.


Using his hand-held computer, Schaaf can scroll through that entire list of those patients, or filter them by which hospital theyre in or other criteria, such as by a primary physician for whom he might be doing rounds. Tapping on a patients name brings up data about the patient, as well as several buttons that can be tapped to get specific pieces of information. One button takes the doctor to a hot list of critical information pre-chosen by the doctor, such as blood chemistry. Other buttons provide lab reports, diagnostic reports, and medication lists. By clicking on a specific medication, the software opens a common drug database that physicians use to check on dosages, possible interactions, and other factors.


In all cases, when data in the patients record has changed since the last download, that specific information is highlighted so the doctor can see it quickly. When lab data indicates something abnormal, that data also is highlighted.


During the pilot project, which ended earlier this week, only a handful of doctors, all from a physician practice called Group Health Hospitalist Service, a unit of Group Health Permanente, were using the system. INHSs Nielsen says another 30 or so doctors will begin using the system this month, along with about 16 clinical pharmacists, who also must make patient rounds.


Within six months, says INHS spokesman Chad Hutson, the system is expected to have some 500 users.


For now, the patient-information downloads are available only at Sacred Heart, though other hospitals likely will add the equipment needed to offer them later, Nielsen says. Because the Meditech system is linked to nearly all area hospitals, doctors who see patients at more than one hospital here could begin their rounds each day at Sacred Heart, so they could download patient data there, then take their hand-helds to other hospitals to do additional rounds, Nielsen says.


Nielsen says the initial cost of the project is about $300,000, including the software needed to run the system and the docking stations. Sacred Heart put that money up; other hospitals that adopt the system also will have to pay the cost of implementing it within their facilities, says Hutson. Doctors, he says, usually will provide their own hand-held computers.


The system works with both Palm Pilot-like devices and the more powerful Pocket PC machines, Nielsen adds.


Though for now doctors will have to go to one of the docking stations, he says, eventually the system will take advantage of wireless Internet technology, so patient information could be downloaded via radio frequency anywhere in a hospital where a wireless transmitter has been installed. Only some handheld computers are capable of using wireless technology.


Schaaf has been a champion here of the use of hand-held-computer technology in medical practices. His doctors group has been using such devices for about four years to provide its members with mobile access to nonclinical patient information, standard protocols, and drug information. He says the addition of clinical data was a natural addition.