Wednesday, September 10, 2008

Wired - Why Things Suck

Wired's magazine article earlier this year titled: The 33 Things that Make us Crazy
featured a section on Medical records

The review was spot on:
Most medical records are about as orderly as an ER on Saturday night. Because they're mainly confined to paper, they can't be easily transferred from one physician or hospital to another. And because they're not subject to any standards (or even legibility requirements), they're nearly impossible to compare and combine.
Harsh but true.....and the ongoing problem of getting everyone to cooperate and share information which is int he best interest of the patient but not necessarily in the best interest og the hospital, healthcare provider or even insurance company:

..because the software vendors selling electronic record-keeping systems are competing, their systems are proprietary and incompatible. Oddly, that's OK with many physicians. Another name for an all-knowing, all-seeing, all-compatible electronic system is database, and physicians don't want people mining theirs — not because of patient-privacy concerns, but because the info could be used for doctor-on-doctor performance stats. Plus, docs already hate filling out charts; you think they want to learn data entry?
The potential cure cited is the arrival of Microsoft and Google as knight's in shining armour - not sure I buy this but I do believe that the entry of large organizations intent on shaking things up is going to have a positive impact. But the key point of advice:
Pressure your docs into accepting a more transparent system.
Agreed - interoperability and the sharing of data is essential. We have been sharing information since the beginning of time. Before the advent of writing, stories were shared, drawings made on walls and information was shared round a camp fire. When new more reliable media arrived (the pen and paper) information sharing moved to this media. Now we have digital media and bits and bytes and we need to wean the industry off its dependence on paper which is no longer effective and start sharing information using standardized compatible formats that everyone can use.


Anonymous said...

Are emr's really better for the patient? If you go to the hospital and the genius attending attributes your symptoms to anxiety, then every Doc you go to in the future will see that and dismiss your symptoms as anxiety related. Chest pain?....well he has a history of anxiety......
Also, when companies figure out a way to pay for this or not...then it will be used to discriminate against you. Bank loan?....wait a minute he has a history of insurance?....same thing. Job interview?....don't want her, she had a breast lump removed.

Nick van Terheyden, MD said...

Thanks for your comments -you make good points
The term YMMV (your mileage may vary) comes to mind. You can put technology or any tool in the hands anyone's hands - it is the intelligent use that is important. There are some elements of displaying information that can contribute and the concept of you the patient controlling and managing and correcting information might also help (this btw is not without challenges and resistance on the part of the medical profession)

The discrimination you talk about is a real concern but to be honest I thin that is already going on. Obtaining insurance with "pre-existing conditions" is a real challenge. I agree we need to watch this area closely and it remains an increasing concern especially as you factor in genetic testing.