2009-07-06

Healthcare Reform 02: Electronic Medical Records

This week seems to have turned into Healthcare Reform week at Cromely's World. Or more specifically, Unresearched Healthcare Reform week. I'm not sure how that happened.

I'll be responding to the comments on yesterday's post tomorrow. But as I think more about some of the issues we encounter, Medical Records is a big one.

The volume of paper work generated by the health care and insurance industries is mind-boggling. We spend hundreds of millions of dollars each year in administration. I don't want to call that waste because without it, so many things simply wouldn't get done, but there has to be a better way.

Besides the cost, there is the hassle for the patients. When you move to another doctor, you either need to get your records transferred or start from scratch. And if a new doctor uses a different system than an old doctor, there is the transition to deal with.

If a patient needs medical care away from home and is unable to speak, ER physicians may also need to start from scratch.

We hear about deaths every year related to mistakes with prescription drugs. A pharmacy may misunderstand a doctors instructions, or a doctor may prescribe a drug that has deadly interactions with something else that patient is already taking and is prescribed by another doctor.

Friends in the medical industry have told me about different electronic medical records system. In my own job, I tangentially have dealt with the issue as well. Thousands of people are involved in various, diverse ways of attacking the paper problem.

Moving all the records off paper and into bits is part of the solution. But it's the next step that I get concerned about.

From a practical standpoint, it makes sense to me to have all medical providers creating patient records in one electronic format that is readable instantly by any other medical professions. I believe Google and other companies are already pursuing this.

The records should be comprehensive. Everything should be in one place, so every healthcare provider knows what the other is doing. And it should be easily accessible for the patient, and easy for an authorized medical provider to access should a patient arrive incapactitated. Information should be easily exportable to the appropriate health insuarnce providers to effectively manage coverage and payments.

Theoretically, such a system could save hundreds of millions of dollars, thousands of lives, and hours of incovenience for patients.

And it scares the heck out of me.

The privacy implications of such a system are staggering. Collecting that much information in one place could put people at risk with employers. It could expose embarrasing information to firends and family. And if it fell into the wrong hands, it is ripe for abuse by conartists.

And if incorrect information makes its way into such a file, it could be painfully difficult to remove and could compromise care for years to come.

In other words, if humans were not involved in the process, I would feel much better about it. But once you factor in human error and greed, the system becomes potentially dangerous.

So I'm torn on whether I want to see such a system in place. There are trememndous cost- and life- saving benefits to such a system. But is it worth the risk to freedom and privacy?

And is such a system inevitable despite such concerns?

4 comments:

Sharkbytes said...

As one with a trail of lost med records ( not because there are so many, but because they are so intermittent), I really think it's a great thing, BUT, I don't want it either at the visceral level. Ghosting Miranda had a post today about putting RFID chips under people's skin with all their info. Now THAT's scary

Pricilla said...

I share your privacy concerns. I do know that my current medical file is 10inches thick. I have to carry it from doctor to doctor and that does not include my MRI and angiogram films. I also have one doctor that won't release my file to me unless I pay him $175 which I just don't have right now. To me that is theft. I could understand a small copy fee but $175?!? It's not a big file 'cause it's not one of my major doctors. So now I have moved cross country and am missing 15 years worth of records due to this man's greed. None of the 11 (yes 11) other doctors I had charged me for my files when I moved. Just this pig.

Rant over.

storybeader said...

It would be nice if the patient could carry the information with them, like a card. But then not all patients would be about to read it. It is such a problem. Privacy is an issue with paper too!

The BoBo said...

Ah..yes...now you delve in to my specialty. The HITECH Act portion of the ARRA forces all healthcare providers, insurance companies, and their Business Associates to move to EMRs and e-prescribe by 2014.

While it does have it's benefits such as an individual getting sick out of area - the out of area physician can access those records back home.

However, the dangerous and extremely disconcerting part of the HITECH Act is that it creates a new government entity and a national database. All of the EMR systems in the country will be directly linked to a database maintained by the federal government.

Now - tell me that isn't big brother! There are 2 really big issues that come with that - 1 - the government will also have real time capability to provide "guidance" to the physician at the time of service as the physician is entering real-time treatment plans in the EMR system (in other words - the government will tell the physician yes or no regarding treating the patient) - and 2 - The freakin' pentagon can't even prevent hackers from accessing their data and servers - what makes anybody think that the entire health information of every single individual in the country can be protected at the federal level?

At this time, the language is mandatory. There are no plans to allow individuals to be able to opt out of having their information sent to the federally controlled national health database.