Although they try to keep up as best they can between patients during the day, it's typical for the nurses at Dr. Anthony Keele's office to have a two-inch pile of paperwork waiting for them at the end of the afternoon.

Most of the papers are faxed requests for prescription refills.

"We spend at least two hours a night just answering faxes," said Debbie Goins, an LPN for Keele. "It's a pain in the rear."

Keele has prescribed a solution for that.

The pain reliever comes in the form of a Web site designed to make refilling prescriptions as easy as a few keystrokes, points and clicks. Keele said everything worked flawlessly when he started using the system Thursday.

The Web site, webmedlink .com, will eliminate the need to fax prescription refill requests. Pharmacists and nurses alike say the faxing process has flaws. Faxes can go unanswered for days at times or get lost. And pharmacists have no way of knowing if the faxes go through.

"I think the Web site is going to be wonderful once all the doctors are participating," said Michelle Flath, office manager at Broadway Prescription, one of two Cape Girardeau pharmacies -- the other is John's Pharmacy -- that has already agreed to try out Keele's system. "You won't have a paper trail, and doctors won't put off faxes. For some doctors, faxes sit on their desks one, two, three days. Sometimes we never get them back."

Keele is soliciting other Cape Girardeau doctors, pharmacists and nursing homes to get on board at no cost. It's a system Keele hopes to market and sell nationally.

The site is a new concept, Keele said, that will link doctors, pharmacies and nursing homes.

Debbie Evans, the director of nurses at Fountainbleau Lodge, a nursing home in Cape Girardeau, said she thought that nurses would need to be monitoring the computers throughout the day and properly trained to operate the program. But she said she would be in favor of anything that would allow nurses to spend less time doing paperwork and more time caring for patients.

The services the site offers are nothing new individually, but Keele, who hired a firm from Dallas to do the program and operate the servers, said this is the first Web site that links everything and everyone together.

Patients who have Internet access can request a refill online or they can still call their physician. If their physician participates with webmedlink.com, patients will save time even if they call in the refill, Keele said, because each patient's medical history is in a secure computer file. So instead of waiting for the nurse to pull out a paper file, it's on the computer screen.

Keele said the ideal situation would be for the patient to make the request online. He would check the site periodically through the day between patients and it would free up his nurses to spend more time caring for patients.

While customers are waiting for their refills, he said, they can check the status of their request.

Dr. Matthew Schumer said a lot of time in doctor offices in consumed in paperwork. He said Keele's idea is a good one.

"Anything that could streamline the old-fashion shuffling of papers and increase our efficiency sounds good to me," he said. "With this, patients have access, so it's an interface for them, too. It's one more way they can get in touch with their doctor. I think it could be a good thing."

Dr. Michael Wulfers agreed, though he wasn't sure how fast it will catch on.

"I could see it saving some paperwork and some time," he said. "It would take some getting used to, of course. Some doctors aren't too computer literate."

Describe and prescribe

In addition to making refilling prescriptions easier, the site will also allow online consultations with doctors, a practice that, though convenient, is somewhat controversial.

The online option, which is being done throughout the nation, allows patients to describe symptoms to their doctors over the Internet. Doctors can prescribe medication accordingly.

Wulfers said doctors have been doing telephone medicine for years and this process would just be a different way of doing that. He said he prescribes some medication over the telephone, like decongestants, but not antibiotics.

"You can't get carried away with e-mail medicine," he said. "There is good medicine out there, but there's no way you can do a physical exam over the Internet, at least not that I'm aware of."

Security concerns

Kevin Kinkade, the executive director of the Missouri Board of Pharmacy, said Keele's idea sounded like a good one, but he had some concerns about privacy, as did Schumer.

But Keele said the site is a secure site, driven by secure servers.

"It's kind of like any site for banks and credit cards," Keele said. "It's practically impossible to hack."

Keele said each individual page is protected by user name and password and only the patient and the pharmacy and doctor that the patient chooses would have access to information.

As of Friday, he had six physicians, three pharmacies and several patients.

"One hundred percent of the people I've shown it to have liked the idea and have signed on," Keele said.

The site is free for patients who want to refill prescriptions. Doctors may set fees, usually $15 to $20, Keele said, for online consultations.

For more information, call Keele at 334-6053.

bmiller@semissourian.com

335-6611, extension 127