Perspective: Doctors' digital duty

When disaster strikes, the country pulls together, making an effort to learn from the tragedy and minimize the impact of future disasters.

Yet there are between 44,000 and 98,000 deaths per year in the United States due to medical errors, many of which are the result of health care system problems. This is the equivalent of one or two 737s crashing every day or the number of deaths caused by Hurricane Katrina times more than 40.

What can help prevent this quiet tragedy? In a November letter to the San Jose Mercury News, a reader said his father "died in spite of having excellent doctors and dedicated nurses. He died because medical care has become incredibly complex and because, as a nation, we have not devoted enough attention to implementing electronic medical record systems."

Little more than 10 percent of the nation's physicians (in 2005) had adopted electronic medical technology.

The letter's author is CEO of the Permanente Medical Group--one of the largest networks of hospitals in the country.

Unfortunately, statistics don't paint a more optimistic picture. A 2005 study conducted by the Medical Group Management Association, found that little more than 10 percent of the nation's physicians had adopted electronic medical technology. In larger hospitals, only about 35 percent of doctors have adopted the technology.

It's not surprising, then, that Hurricane Katrina destroyed an estimated 1 million paper health care records.

In the face of this national embarrassment, the Bush administration called for electronic records for most Americans by 2014 and a national health information network that links the nation's hospitals and doctors.

Yet movement forward has not been nearly as fast as it could be because of, among other reasons, lack of technological standards, implementation costs and legal hurdles.

This is why meaningful Congressional legislation that begins to deal with these issues should be passed this year. These issues should not be set aside, leaving a new Congress to start over on them. The House of Representatives took an important step when it passed legislation this summer that would help health care providers apply for grants to help implement new technologies, remove legal barriers to implementation and foster the creation of regional health information networks.

The Senate unanimously passed a more robust bill last November that included additional funds and also ensured uniform standards for keeping electronic health care records to guarantee compatibility across different networks.

With relatively few days left in this congressional session, we are hopeful that House and Senate leaders can resolve the differences between their respective bills and give President Bush high-quality legislation to sign. We are also encouraged by the president's August signing of an executive order that will require that all providers of federally financed health care to adopt quality-measuring tools and uniform standards for their information technology.

Still, Silicon Valley is not sitting back, waiting for government to act. Technology's best are teaming with health care providers from across the country.

Our two companies are developing an electronic health record-sharing system to eventually link the records and lab results of 3.5 million patients in Pennsylvania and make their information accessible in regional hospitals and health systems.

As other localities across the nation create similar systems, they will be able to link together to fulfill the ultimate goal of creating a national network for health care information. Research firm Gartner thinks the money that will go into this effort will pay off in innumerable saved lives. They predict that "it could enable clinicians to reduce the level of preventable deaths by 50 percent by 2013."

Still, the United States is playing catch-up. The United Kingdom, for example, is so convinced of the benefits of electronic records and a health care network that it's spending $17 billion to wire every hospital, clinic and doctor's office in the country. The country's National Health Service is rapidly improving health care delivery for its citizens while looking to reap economic and productivity benefits for its national health program.

Nearly three out of four Americans believe strongly that electronic medical records can make the difference between life and death in emergencies. It's time to recognize that our dated medical system is in a state of emergency and act with urgency to make it state-of-the-art.

Biography
Wayne Owens is the senior vice president of health care at Sun Microsystems. Frank Richards is the chief information officer of Geisinger Health System.

More Perspectives

[Amigoid]

Dammit Jim I'm a Doctor, not an IT Geek

My wife works as a Chiropractor at Kaiser and they are working towards more computer entry of the patients data, however more work needs to be done to help teach/support Doctors in using this technology. She's not a luddite; she has her own desktop at home and is comfortable using IM and email, but the computer systems are still not user-friendly. Don't even get me started on whats required for Medicare Part B support. We spent months trying to get that set up to work for her older patients and its so much of a hassle that she no longer offers that for new patients. I can only imagine there are many other small practices that are overwhelmed with HPPA privacy regulations, and all the hoops involved to switch to electronic filing for reembursement, that they instead to just opt for a cash practice.

[TomMariner]

Standards Exist

I am in the medical imaging part of Electronic Health Records and have been in on many official and unoffical conversations about the plan to use IT to improve our health care system.

Most plans I see start out with the comment that was in the article that we have to set standards. Wrong! That is a total waste of time and will do nothing but create jobs for mega degreed folks who will redo work that has already been done and ratified.

In my end of the business the standard is DICOM and it specifies everything from how a physician can order an imaging study to how the resulting images are stored, viewed and connected to a patient. Most other areas of health care have similar standards. If we really want to get this thing done in our lifetimes we have to immediately accept whatever protocols and standards have been worked out over decades and begin implementing them. Since most of the definitions are in object terms and are concise and unambiguous, they are very easy to convert to modern computing systems, say XML.

I hate to put a billion dollars worth of consultants and goverment employees out of work and save five years, but if it is a crisis, let's act like it and get to a conclusion as expeditiously as possible.

By the way, since emergency care (which is a part of healthcare) has to do with treating catastrophy victims, we will also be striking a blow for effective homeland security.

[casstee2000]

If Dr.'s wont, patients should !

If physicians cannot or will not move into the safer digital medical record arena patients need to know that they can. Virtually every study on the efficacy of EMR?s concludes that they can create a safer and better medical outcome at a LOWER expense. Medical errors are expensive in their human and monetary toll.

As I thirty year hospital health care provider I can attest to medical mis-communication as the primary vector causing sentinel events causing unnecessary morbidity and mortality.

Patients need to be as responsible for their healthcare safety as they are for any component of their adult life. It is an unreal expectation to think that a doctor seeing 40-50 patients a day should be more responsible for your health than yourself.

The best way to be a knowledgeable and empowered patient is through knowledge and effective communication with your providers. Personal Health Records (PHR) will accomplish this goal when physicians will not. A PHR will aggregate your specific medial history including emergency contacts, allergies, medical history, conditions, medications and any possible interactions. Most importantly, you control who sees what and when. In the event of a disaster, moving, seeing a new specialist or traveling for business you can always be prepared by having your information available in a standard XML, CCR format. You can download your digital information on a simple USB flash drive and always have it with you.

Some PHR only exist out in cyberspace. I for one want more control over my privacy by controlling my own medical record.

Consumer driven healthcare demands that patient be informed consumers and optimize their care. Perhaps the medical digital revolution needs to start from a grassroots swell- the patients!