Total Recall - C. Gordon Bell [40]
HEALTH E-MEMORIES
It was recently reported that a university study of more than forty hospitals and 160,000 patients showed that “when health information technologies replace paper forms and handwritten notes, both hospitals and patients benefit.” Neil R. Powe, M.D. from the Department of Medicine at Johns Hopkins University School of Medicine and director of the Welch Center for Prevention, Epidemiology and Clinical Research was the lead author on the paper announcing the findings. He said, “If these results were to hold for all hospitals in the United States, computerizing notes and records might have the potential to save a hundred thousand lives annually.”
Good information is central to good health care, and the old-fashioned paper-based system is inadequate. Most hospitals have not caught up with the efficiencies of our digital world. Many laboratory tests are performed needlessly because of missing paperwork. One study found that while the patient’s chart was available 95 percent of the time, 81 percent of return visits were plagued by missing information. RAND has estimated that the U.S. health care system could save an estimated $77 billion each year from the improved efficiency of electronic health records. Health and safety improvements double that figure.
The paper-based system is not just inefficient; it can be dangerous. In American private-sector hospitals and nursing homes, as many as one in five medications are given in error, harming at least one and a half million people every year, with 7 percent of those errors being potentially life-threatening.
Compounding the issue is a projected increase of chronic illness. We are in for an explosion of chronic ailments as the Baby Boomer generation passes into seniorhood through the 2010s and -20s. Eighty-eight percent of seniors have chronic conditions that require ongoing management and become increasingly expensive the longer they are left untreated. As the baby boom becomes the senior boom, our health record problems will multiply.
Thankfully, paper-based health systems are on their way to extinction. Health-care providers around the world are moving to electronic health records, keeping an e-memory of your medical records instead of paper. Being digital, they can be easily accessed, copied, or updated from anywhere within an institutional intranet or, in some cases, via the World Wide Web. The institution that maintains your records uses them to log every health-related event and transaction relating to you as a patient, from treatment records to consent forms to insurance billing to test results.
The United States Veterans Administration, which cares for the health of the nation’s ex-military personnel, has adopted electronic medical records and other computerized systems with fabulous results. It has almost eliminated prescription errors and the need to duplicate lab tests. Many private American institutions are also implementing electronic health records (EHRs). Kaiser Permanente is aiming to deploy the nation’s largest electronic medical records system by 2010, covering 8.4 million members, 431 medical offices, and 32 hospitals in 7 states. Hoping to shave down high costs of providing insurance for their workforces, a consortium of major companies, including Intel, Wal-Mart, and AT&T, are working to provide electronic health records for their employees.
State-run medical systems can dictate EHR adoption, and even the central storage of all information. The British National Health Service is mandating a move away from paper, with a central EHR system dubbed “the spine.” The European Union adopted an e-Health action plan in 2004, which includes e-prescriptions, e-referrals, and teleconsultations.
But while there has been considerable progress toward EHRs, a lot of work remains. The San Diego County Medical Society Foundation believed in 2003 that they were only a year away from a regional information network but, as of 2007, still remain “years away from full scale EHR adoption,” according to The San Diego Union-Tribune.