We'll all soon have electronic medical records, given the $19 billion tagged for a big rollout of the long-touted paperless systems in the economic stimulus plan. Healthcare experts say EMRs will make medicine safer, more efficient, and more cost effective, and three quarters of the public say they're all for it. But will the electronic records really be better than the chaotic paper-based system we've got now? Here's the latest, gleaned from research on health IT in the current edition of the policy journal Health Affairs and a meeting of EMR superstars in Washington, D.C. The bottom line: Electronic medical records are essential, but they're far from simple. "As a software guy, I'm really optimistic about what technology can do to improve healthcare around the world," said Peter Neupert, a Microsoft vice president. "And as a software guy, I think: Holy crap, this is really going to be hard to do." Here's what they can do now:
1. Skip trips to the doctor. It's a pain in the buns to have to trek to a primary-care doctor every time you need a question answered or a prescription reordered. Primary-care office visits in Kaiser Permanente's Hawaii region dropped 25 percent from 2004 to 2007, after the healthcare organization started offering people the option of E-mailing doctors as part of the 8.7 million-member organization's Web-based electronic health record. No need to take time off work, and no miles driven; this even helps fight global warming! But since most doctors outside of a group program like Kaiser don't get paid for E-mail consults, this might be a tough sell.
2. Track Mom's medical chart even if you're in Albuquerque or Altoona. Online personal health records like Microsoft's HealthVault and GoogleHealth make it much easier to share medical records among family members, which could be great for managing aging parents' healthcare. The downside: Very few doctors and hospitals are set up to let you download your records onto these third-party sites, so for now you might have to type it all in yourself. "A personal health record is really an electronic notebook," says Alfred Spector, a vice president at Google Inc. "It's under the patient's control."
3. Get lab test results without having to play phone tag with the doctor's office. Some clinics and labs, including Beth Israel Deaconess Medical Center in Boston and Quest Diagnostics, let customers download lab results the moment they're reported. Kaiser Permanente patients viewed 16,773,273 lab tests online in 2008. That's faster access, for sure, but many test results read like gibberish. Will insurers or labs help with interpretation, or will we still have to ask the doctor?
4. Never again drag X-rays to a specialist. X-rays and other diagnostics are going digital, and big IT companies such as Cisco are designing systems that would make it possible to store and retrieve a lifetime's worth of X-rays and MRIs. Doctors might start incorporating digital photos as part of a patient's record, like dermatologists already do to screen for skin cancers.
5. Find out if your prescriptions could have dangerous interactions, before you start taking them. This year, Medicare starts giving physicians a 2 percent bonus if they use an electronic prescription system, which automatically checks for correct dosage and potential drug interactions. That could finally give E-prescribing the boost it needs; most docs still write scrips by hand. Health plans that have switched to E-prescribing report that it's saved them millions of dollars by helping them shift patients to cheaper generic drugs. Safety advocates add that E-prescribing reduces dangerous errors by doctors and pharmacists.
6. Use your cellphone to tap into your health record from the mall—or from Mali. Cloud computing is the next big thing on the Web: Your data live somewhere up in the ether, and you access them via phone or laptop. Web-based personal health records like Google's are in the vanguard, but more traditional health record providers like Kaiser will probably follow. The big plus: You or a doctor can access your health records anywhere in the world. The obvious big minus: Cloud computing may be less secure than your sock drawer. Last April, health insurer WellPoint disclosed that the health records of about 130,000 customers had become publicly available over the Internet.
My colleague Bernadine Healy discusses the many privacy problems surrounding electronic medical records, and my fellow senior writer Michelle Andrews explains how EMRs can increase the risk of medical identity theft. Dave LaGesse reports on how half of people say they'd use a personal medical record from a third party like Microsoft or Google.