File under 'Hodgepodge'
Adler, Jerry, Newsweek
Byline: Jerry Adler
We need a national system of electronic medical records.
If you're like most Americans, you like to take responsibility for your own health, even the aspects of it that you find boring, incomprehensible or just icky. You keep detailed records of every doctor's visit and medication, just like you do for every tax deduction, maybe even in the same shoebox. You know that your blood pressure is the one with two numbers, right? and that your hay fever cleared up with those yellow pills from Dr. What's Her Name, with the accent, and that you had your last checkup for colorectal cancer right after that series on the "Today" show. If that's you, you can stop reading this right now. Just remember to take the shoebox with you to the hospital.
Actually, it's not that simple. A major change is occurring in medical record keeping, driven by the embarrassing realization that until now the information systems that keep track of Americans' cancer treatments have mostly lagged behind the ones they use to buy movie tickets online. "Eighty percent [of small practices], which provide more than half the medical care in the country, do not have computerized clinical record keeping," says Dr. David Kibbe, a leading consultant on health-care technology. They keep patient records in file drawers; the doctors scribble prescriptions on pads of paper and communicate with other health-care providers by picking up the phone and calling. The Obama administration's economic-stimulus package allocates almost $20 billion to help move this jury-rigged system into the 21st century, including direct subsidies to physicians for purchasing health-records systems -- as soon as the nation figures out what the system should be.
In health-care think tanks there is frustration bordering on panic over the danger that the nation will miss a historic opportunity if millions of American doctors adopt a hodgepodge of stand-alone systems that don't readily communicate with each other. "Whatever is done has to be accompanied by a whole series of other changes," says Shannon Brownlee, Schwartz senior fellow for the New America Foundation, which is in the forefront of studying this issue. "There are a whole series of good little ideas in health care now, but if each is implemented separately it won't add up to an improvement. We'll end up digitizing a really bad system."
At a minimum, experts say, a national electronic health-records system should do the following:
* Permit immediate electronic information exchange between doctors, saving time on taking patients' history and money on tests or X-rays that may have already been performed. …