The 2nd Annual Ladies' Home Journal Health Breakthrough Awards

Craig F. Feied, MD, and Mark S. Smith, MD: Modernizing Emergency Rooms

Ladies' Home Journal has regularly reported on the strain on the nation's ERs. Now two physicians from the emergency department at Washington Hospital Center (WHC) have devised a dazzling computer system that may be the most significant tool to improve emergency-room care in decades. Bought last year by software giant Microsoft, it's now spreading nationwide.

Mark S. Smith, MD, and Craig F. Feied, MD, friends and colleagues since 1983, were as frustrated as their ER patients by the long wait times, made worse by doctors' inability to quickly access information on a patient's health history. "We were making decisions in a vacuum," says Dr. Feied, 53. "The only information I had was what a sick or injured patient could tell me." Any earlier medical records the hospital had were very hard to access. "That doesn't help you make life-or-death decisions," he says.

Before entering medicine Dr. Smith earned a degree in computer science, and Dr. Feied in biophysics. Both were fascinated with an emerging field called medical informatics, the study of how medical information is handled. Both felt healthcare was light-years behind.

"There is more information technology at an Avis or Safeway checkout than there is at most hospitals," says Dr. Smith, 60, who became chairman of WHC's department of emergency medicine and professor and chairman of emergency medicine at Georgetown University School of Medicine in 1995. He hired Dr. Feied as director of the Institute for Medical Informatics.

In January 1997, after just 13 months of work, the duo launched a software program in WHC's emergency department. Called Azyxxi, it gathers all medical data the hospital has about a patient (blood work, x-rays, an ultrasound, etc.), no matter which computer program stored it originally. The software creates a new file for each patient and lets staffers call it up in just one-tenth of a second.

Azyxxi's effect was seismic. ER wait times dropped from about six hours to about one, allowing 37,000 additional patients per year to be seen. Later it was adopted by the six other hospitals in WHC's MedStar Health network, which attracted Microsoft. Dr. Feied is now general manager of Microsoft Health Solutions Group, while staying a professor at Georgetown. Next in line: New York-Presbyterian Hospital, in New York City, the Johns Hopkins Health System, in Baltimore, and the Wisconsin Health Information Exchange.