High-Tech Medical Records: Can Electronic Records Transform Health Care?
Mertz, Kory, Folkemer, Donna, State Legislatures
In the middle of a legislative session, a veteran legislator from an out-county district walks into the ER near the Capitol complaining of a headache and nausea. He is handed a stack of forms to fill out. Unable to recall most of this information, he is forced to leave many fields blank, including the names of his many prescriptions. To fill in all the missing information the doctor has to run a host of tests, some very expensive. The legislator is sent home to await the test results feeling no better than when he arrived. The state loots the bill.
This is the current state of affairs in health care. Now envision this situation transformed by information technology.
The legislator enters the ER and a nurse pulls up his complete electronic health record within seconds. No forms to fill out, no prescriptions to remember. The doctor reviews the lawmaker's record and notices that his five medications were prescribed by four different specialists. After speaking with the patient, the doctor deduces the symptoms are likely the result of a bad prescription interaction. Checking her findings with a computer system that helps make clinical decisions, the doctor prescribes an alternative medication and updates the patient's record. The prescription is electronically sent to a pharmacy of the legislator's choosing. No paper, no agonizing wait for the legislator and no redundant--and expensive--testing.
Former Speaker of the U.S. House of Representatives Newt Gingrich and others see health information technology (IT) as key to fixing a dysfunctional health-care system. "Health information technology is essential if we are to make any meaningful change, from reining in costs to improving the delivery of care to expanding insurance coverage. We simply cannot continue to prop up a 1950s paper-based system and expect anything to change," says Gingrich, founder of the Center for Health Transformation.
Instant access to vital health information can save time, money and, ultimately, lives. When doctors see a patient's complete medical history, they can make better decisions by preventing harmful drug interactions and eliminating duplicate tests or procedures. The Center for Information Technology Leadership estimates that this kind of technology would save $77.8 billion a year--or about 4 percent in a $2 trillion health system.
But moving health care into the digital age will be far from easy.
First, doctors, insurers and especially consumers must embrace electronic heath records that gather all of a person's health data from childhood to the present into one digital record. Many consumers fear that the transformation from a paper to a digital system will make them more vulnerable to unauthorized exposure. They fear that if their medical histories fall into the wrong hands, they'll face workplace discrimination and a loss of insurance. Also, patients are concerned their private data will be used by various groups for marketing purposes.
"In the current health care 'system,' consumers have little or no understanding--let alone control--of the movement of their health information," said Alison Rein of AcademyHealth, a policy research organization. "As we enter a more data-rich, fluid exchange environment, a challenge will be to figure out where and to what extent consumers should have more input into the process."
Paying for health IT is another barrier. Insurers and other payors can save money through electronic health records, but providers usually have to pay for the systems and staff retraining. Small practices, rural providers and community health centers are especially fearful of new costs.
There are also turf battles. For this technology to work, organizations must share data, and some health-care groups are reluctant to share what they have traditionally seen as theirs alone. They may believe that sharing will hurt their competitiveness. …