The US government is encouraging doctors and hospitals to ‘go green’ and use digital medical records. Computerized records have so far been shown to be a valuable asset in patient care, giving doctors armed with tablet computers (I guess we’re entering the age of the iPad doctor) immediate access to patients’ medical records (such as immunization histories), with a reduction in medical error and repeated tests. The 2009 economic recovery package allocated some $27 billion to doctors’ offices and hospital as an incentive for switching to digitized records, but, with the new Republican-majority Congress looking for budget cuts, those monies could be on the chopping block.
Aside from quicker, more ready access to patients’ medical histories, digitized medical records offer other benefits, as the data can be ‘mined’ and analyzed to ‘find what treatments are most effective or to get early warnings on dangerous drug interactions.’
As today’s New York Times says, only 30 percent of physicians currently use digitized records and mostly those working for large health care providers such as Kaiser Permante and the Mayo Clinic. With most doctors in small practices, they simply don’t have the financial and technical support to make the costly change to computerized records.
The Obama administration, working with health professionals and the technology industry, initiated a program last year under which doctors can receive incentive payments of up to $44,000 for switching to digitized medical records and following certain criteria to determine that the records are being used ‘meanincful[ly].’ The program begins this year, and participants must follow requirements for using the records to report and share health information which increase in stages through 2015. Thereafter, doctors who do not meet the ‘use and reporting rules’ will be charged with penalty payments from Medicare and Medicaid.
The change is not expected to be either quick or painless:
“Islands” of such learning networks already exist, notes Charles P. Friedman, chief scientist in the federal health information technology office. By mining its patient data, Kaiser, for example, was first to identify a link between the pain-relief drug Vioxx and a higher risk of heart failure, well before Merck pulled the drug off the market in 2004.
Yet the road to a national computer-enabled learning system, specialists agree, promises to be long. A major obstacle is that so many doctors, especially in small practices, are leery of technology they see as needlessly hard to use and time-consuming. “Doctors don’t want to become clerks,” says Dr. Isaac Kohane, a health technology specialist at the Harvard Medical School.
And complex technology- designed for big health groups, not small practices- could well increase medical mistakes, specialists say.
As the Obama administration’s national coordinator for health information technology, Dr. David Blumenthal, notes, the intent is to ‘gradually build consensus on policy and technical standards rather than issuing edicts’ about when and how doctors and hospitals use computerized medical records.
Health policy analysts have noted that they think it unlikely that the legislation to encourage adoption of computerized medical records will be overturned. Certainly when we have been consulting with our son Charlie‘s neurologist about whether his medications are helping are not, it would be more than helpful for the doctor to have detailed information about his medical history, medication dosages, behaviors issues, and more.
Should this be the kind of program our government should be investing in right now?
Photo by mandiberg.