While many doctors already use hand-held computers to make prescriptions electronically, this system would go much further. It would allow doctors to use laptop computers to tap into the details of a patient's medical files; to view lab results, diagnostic images, even vital signs of some hospitalized patients; and to make sure they bill correctly for services.

UC Physicians plans to "go live" with the first part of its system in spring 2005.

For UC Physicians, the project is expected to make changes in the day-to-day practice of medicine about as sweeping as a new computer order-entry system launched in 2002 by Cincinnati Children's Hospital Medical Center.

"Implementing an electronic medical record system is the single change that most profoundly affects patients safety and quality of care," said Dr. Michael Privitera, medical director for UC Physicians.

UC Physicians has a truly massive amount of medical information to manage - in the past year alone its doctors handled more than 280,000 patient visits and began treatment for 43,731 new patients.

Here are some ways a new medical record system could affect patients:

• Allowing computer prescription orders that eliminate mistakes from pharmacists trying to interpret illegible handwriting.

• Automating alerts that warn doctors if a new medication might trigger an allergy recorded somewhere deep in a patient's files, or clashes with another medication ordered by another doctor.

• Allowing doctors from various specialties to see if another doctor already has ordered a blood test or diagnostic scan.

• Reminding staff when patients are due for vaccinations or follow-up exams.

• Allowing doctors to check whether treatment plans conform to recommended standards, and in increasing numbers of cases whether the medication or treatment would be covered by a patient's health insurance.

All of these changes can help patients avoid complications and can save money for the health care system by reducing duplicated or unnecessary tests.

UC Physicians expects to pay about $1 million a year in access fees to Integrated Management Services, a part of the Health Alliance of Greater Cincinnati that will actually buy the computer system and hire most of the people needed to run the system.

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E-mail tbonfield@enquirer.com