We had a great response to our last posting, a summary of President Obama’s Healthcare plan. This week we want to dive into the detail on the proposed $50 billion ($10B a year for five years) investment to move from paper to electronic health records.
Electronic records allow medical teams to work together and share information. This reduces errors, improves quality, and reduces cost. President Obama’s plan calls for uniform standards for sharing information between systems. The money will create the tools to allow all health workers to access information electronically.
I have supported electronic health records for over a decade. I know firsthand how it improves office visits. Electronic records help make sure clients receive the right tests, the right medications, and the right referrals for specialty care. In the emergency room, I have seen how the lack of a complete patient record causes mistakes. These mistakes, such as giving a medication the patient is allergic to happens every day. A national electronic record would immediately help prevent these issues.
The benefit of moving to electronic records is great. So is the danger. These records contain private, personal information. Today a small number of people have access to our paper documents. Once the information becomes electronic, the numbers of people with access increase. The most important issue is control of this information. We should be able to access our own information. We should be able to see our conditions, our medications, and our test results. We should be able to define who we want to have access to this information. We want our doctors to have access. We want our nurses and our medical caregivers to have access.
However, there are other risks. For example, drug companies might use this information to identify people with a certain issue (like high blood pressure). Using this data, the drug company could try to sell their drugs to targeted patients. The electronic health record must be protected against any attempts to market, or profit, or use our personal information in any way not directly tied to delivering healthcare.
We must demand control of our information. We must own the information and the ability to give others access to it. There are many great companies working on the electronic medical record. We need a seat at the table, to make sure our voice is heard and that we own our own data.
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The ease my husband experiences when he visits the VA has been impressive to him. He walks in and all his records are online for the doctor and nurse's to expedite his visit.
ReplyDeleteAs for myself, I can never remember all the pertinent information needed unless I write it all down to take with me to the doctors. If I was out of town and had an emergency the convenience of having the information available to those who may be saving my life would be a lifesaver!
Even as a physician, when I or my children have a medical issues, it is difficult to remember past medical history or who in our family had what. A comprehensive electronic Personal Health Record would pay for itself over in multitudes. The VA system is one standard many people are pointing to as a success. We are true supporters of this issue and hope we as a nation could quickly move to retrieval of this information anywhere in the nation (or the world for that matter). I believe that we as individual Americans should "own" this Personal Health information and become our own stewards or gatekeepers of the data.
ReplyDeleteDr. Knight, I do have some concerns in regards to electronic e-mails. My concern is of Hackers who can alter records or hack into and write prescriptions for drugs. I do believe we need to cut down on paper trails and electronic e-mail is the way. I just hope they can encrypt these and only allow a select few to gain access.
ReplyDeleteWe need a strong encryption to keep all intrusive eyes away. This includes employers, or potential employers, who may try to use this data as a screening technique to avoid putting people on the payroll who may be pregnant, have a genetic tendency for some illness, or a host of other "non preferred" medical or health conditions. Lawyers could use this to screen for jury pools, employers for jobs, and/or promotions, and government or security sensitive employment areas for a variety of things. We need to be in control of our own data.
ReplyDeleteAnd while we are taking information to the electronic age, lets make insurance forms standard and electronic too. If I recall correctly that would save billions every year if we keep the current for profit insurance system. There is no need for each insurance company to have it's own individual paper based form that varies only in spacing and bolded areas.
Hey Summer, great job. It is appreciated to see an "easy read" for the new administrations ideas for moving forward.
ReplyDeleteThanks....
Jeff Brewer
jeffbrewer@fairisaac.com
I have been giving this notion of federalization of medical records some thought; I do not like the notion that the Federal or state government for that matter have this type of information.
ReplyDeleteHistory has proven that government, especially big government can not be trusted.
And the fundamental issue we are voicing is that yes, we want electronical Personal Health Records because we understand it is efficient, effective, can save lives, and save dollars. We are also voicing that WE as individuals must be the owners of this data. In such a scenario, our data is not available to others such as government or big business unless we give them certain permissions.
ReplyDeleteAs well, Larry, a uniform application form is a plausible idea. My direct experience with that model was in medical school applications when they went to a uniform application system. However, even though most of the schools agreed on the application form, they still insisted on each person sending a separate personalized package. We would need to ensure that would not happen with the insurance applications.
Summer,
ReplyDeletePrivacy issues like this abound with all sorts of data. There will simply have to be enough disincentives in place to make the risk of tampering greater than the reward. Otherwise, we won't move forward.
Scott Atwell
Access to sensitive data is always going to be an issue. Whether it be someone looking at paper records or electronic records. Yes, electronic access does make it easier to scan large quantities of data quickly. I would suggest that levels of access be implemented, some personnel might not need access to all of your information, while others would. Encryption of sensitive data is a must. All access to any of your data should be logged for an audit trail, something that's not available for paper records. Biometrics and or Smart card technology could be used to reduce the risk of security breaches. As you say, just because we can, should we? I think on this one the answer is yes, but it needs to be implemented with great care.
ReplyDelete