History

T-System's goal is simple: Offer the industry's most user-friendly, advanced solutions that help improve patient care starting at the front door.
Most businesses have humble beginnings, and T-System is no different. But what started as a simple idea evolved to fundamentally change emergency care in the U.S. forever. This is the story of two dedicated physicians whose innovative idea has been adopted by more than 1,700 emergency departments (EDs) nationwide.

During the 1980s, Woodrow Gandy, M.D. and Rob Langdon, M.D. met while working together in the emergency department (ED). Throughout the years, they saw their hospital's average ED patient volume skyrocket from approximately 35,000 to 50,000 annual patient visits. Nationally, the number of ED visits multiplied by more than 2 million per year between 1993 and 2003, from 90.3 to 113.9 million visits – an increase of 26 percent in one decade. Patient documentation was, at that time, done through handwritten notes or dictation, and the doctors found themselves struggling to keep up. It was not uncommon for them to work 18-hour shifts to ensure they had enough time to document patient records and do their own billing.

Concerns about medical malpractice and continuously evolving healthcare regulations added to the stress of the ED physicians' jobs. In the mid-90s, Drs. Gandy and Langdon came up with the idea to develop a template documentation system to help ED clinicians chart and solve up to 150 patient complaints in a visual way. They initially envisioned the system as a software program but decided to first perfect the templates on paper, incorporating clinician feedback from thousands of patient encounters. The template system, which allowed clinicians to document using circles and backslashes, helped them see patients more quickly, created a more thorough record of a patient's visit, and offered better medical and legal protection.

Doctors Gandy and Langdon, Founders of T-System During the next year, Drs. Gandy and Langdon spent countless hours working on their new documentation system and strategizing how to implement it at their first client site. They studied workflow processes, how every inch of space in the ED was used, how the doctors could be most easily trained, and more.

When it was time for a trial period at the first client site in 1996, Dr. Langdon asked doctors to mark a "T" on a patient's chart if they'd used the new template system or a "D" if they'd dictated the chart. When Dr. Langdon returned to the site two days later, he pulled a stack of charts and found that every chart had a "T" marked on it, indicating that the new system worked and had quickly been adopted. Drs. Gandy and Langdon decided to name the company T-System because "T" stands for template, and the company was built on the idea that emergency medicine could be divided into a few dozen problems that ED doctors and nurses see commonly. Each template is a visual roadmap to a problem.

T-System Early Years At ACEP In the early days, Drs. Gandy and Langdon's homes were transformed into offices and production centers. They built the shelving units and made and stored template copies in their garages. They printed so many templates, named T Sheets®, that they found themselves having to replace their printers every two to three weeks. Over time, T-System's client base grew rapidly by 50-60 hospitals per month. T Sheets became a stage prop and part of the script on the hit television show "ER." The T-System exhibit booth at the American College of Emergency Physicians (ACEP) conference would swarm with attendees.

A new T-System era was born in 2001 when T Sheets were adapted and expanded into a comprehensive ED information system (EDIS) known today as EV™. Leveraging the content of the T Sheets, EV™ allows clients to spend more time with patients, improves care quality, reduces medical errors and organizational costs, and helps clients demonstrate Meaningful Use.

T-System Offices Today, after 15 years in business, T-System Inc. offers an array of solutions to more than 40 percent of the EDs in the U.S. T-System solutions are the most widely implemented and used in terms of market share and number of clinical users. In addition to being used in traditional EDs and urgent care centers, T-System solutions can also be found in a variety of unique care settings, including at national sporting events and natural disaster response scenes as the sole patient care documentation system.

Moving forward, T-System's goal is simple: offer the industry's most user-friendly, advanced solutions that help improve patient care starting at the front door.

1. AHA, 2005b: Mcaig and Burt, 2005.
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