The debate and discussion about electronic health records or patient records is getting louder than the noise Seattle SeaHawk’s 12th man can make during the home game. Backed by both presidential candidates and some of the biggest technology companies like Google, Intel and Microsoft, it can’t get muzzled out that easily. So you might think that we are entering a breakthrough age led by these giants and finally the area of digital health care is dawning upon us. Hold your horses. It is not that easy as it seems.
The idea and motivation for the electronic health records or patient records or medical information system, whatever you call it, is to get the patient information in digital format so that it can be shared by doctors, insurers and others easily. The benefits of such sharing or collaboration could be to cut time for finding cure, avoiding delivering wrong treatment and the mobility of the patient records. It can also cut costs for maintain paper and the time for patients to wait to fill it out during visits.
The challenge is really simple: Trust. Confidentiality and privacy concerns are outdoing the chance to get on this bandwagon. Critics also point out that privacy violations; technology risks and potential of such data being used for promotional purposes are far too risky to enjoy the benefits. Nobody wants to trust the corporate profit-mongers with the essential data about health and then see themselves getting hijacked by the keepers of the information. No one has forgotten hassles of do-not-call lists, spam is still not dead and hackers never go away. So much for giving away your telephone number or email, what will happen once your entire health history is online? Just shudder to think what will happen once someone out there on the crazy anarchic internet knows about your irritable bowel syndrome. You will soon be bombarded with ads promoting the cure or you will become an office joke if your team member finds about it. That google search can be nasty you know. Additionally, the patient records should not be at the mercy of these business models but really should be decoupled to deliver the benefits without the profits.
One point being overlooked is the bottom-line in these discussions: Information. It is all about the information. Information about the medical knowledge, ability to find such information in time, almost anywhere with security in place so that it could be used for proper diagnosis in due time and save lives. Information which hospitals, patients, insurers and governments can use in a better way to reduce the time taken for approvals and delivering patient care. The right information at the right time can really make a difference between life and death.
The power of information is really the victim in this clash of health care IT and the privacy concerns. It is amazing that in such a information-critical area of practice, the medical information systems still lacks the modernization that can be delivered by the technological innovations available today. Health care industry will spend approximately 30 billion dollars in IT investments this year, about same they spent in 2007 and on par with estimated spending for 2009. This goes with the historical trend in healthcare IT. While pharmaceutical companies spend billions of dollars way more than 30 billion in new drugs, hospitals don’t spend nearly enough to get enough information about these drugs at the first place. That is why the incidences of drug side effects, improper dosage guidelines and lawsuits for the advertised drugs are increasing.
The technology to deliver this power of information is available and has been implemented successfully by a lot of big corporate, US government, Pentagon and the likes. For health information, what is needed is a way to deliver it in a fashion that makes sense to all the stakeholders. May be instead of the idea of Google Health, HealthVault (Microsoft) and Dossia (Intel) which gives patient information to a corporation’s data center; patient information should be owned by patients to start with. The patient records should be normalized to start with and the patients should be allowed to transmit these records electronically to the doctors prior to their visit. This can follow the model of tax preparation and filing to IRS. Individuals are responsible for preparing their tax returns and submitting to IRS. You can take assistance from CPAs if you wish but ultimately IRS will hold you responsible. If we are comfortable submitting our vital financial information to CPAs, TurboTax.com and IRS; then similarly we would feel comfortable with our health information.
All hospitals and doctors can install kiosks at their lobbies to assist patients in creating such records and electronically submitting it to the doctor’s office. This would reduce the time for patients or at least make it predictable. This would also avoid all the hassles of maintenance and storage of the paper records. The electronic health repository would make the search for information easier and help doctors to submit claims to insurance agencies much faster. This can spawn whole ecosystem of software, services and support for electronic health information or medical information systems. This will lead and improve the collaborative healthcare between internal medicine practitioners, surgeons, radiologists, labs to deliver a comprehensive health care for patients.
So, pay attention Healthcare IT – adopt collaboration and improve the state of healthcare in US.
