exploratory essay
Source:
Newsweek. 10/16/2006, Vol. 148 Issue 16, p63-63. 3/5p.
Abstract:
The article offers a look at communication gaps in medicine that happen because records sent from one hospital to another are written in longhand. According to the authors, the most important benefit of electronic records is the ability to deliver information to doctors as they are making decisions about patient care.
DIGITAL AGE/ FROM HARVARD MEDICAL SCHOOL
If you're a patient, there are many things it's perfectly reasonable to expect from your doctor and from the health-care system. If you visit an emergency room while traveling, it should send your doctor all the details. If your doctor refers you to a specialist, the specialist should have in hand all the pertinent information about your health by the time you walk into her office. And if you are hospitalized, the medicine that's brought to your bedside should be the one your doctor ordered.
Perfectly reasonable, indeed, but many of these things do not reliably happen because your doctor and the health-care system still largely use paper to communicate. This paper is shuttled from one hospital to another, often doesn't arrive on time and sometimes doesn't show up at all. Some of the most important information is written in longhand, and how legible is your doctor's handwriting? We now spend nearly $2 trillion a year on the preservation of our health. Yet we still rely primarily on antiquated record-keeping.
Fortunately, there is a growing movement to change that, using electronic information technology. While only 24 percent of providers today use electronic health records in their offices, that figure is increasing rapidly. More doctors are using computers to order diagnostic tests and treatments. Gradually, institutions are building systems with common coding systems that allow them to exchange data.
In our view, the single most important benefit of electronic records is that they make it possible to deliver information to your doctor at the moment he is making decisions about your care. Instead of having to read through what can be hundreds of pages in your medical record to find a particular test result, he now has the data available in an instant.
Technology is also making it easier for patients to communicate with doctors and participate in their treatment--enabling them, for example, to transmit important information like the blood-pressure readings taken on home machines.
Prescribing medicines is also getting a lot safer and more efficient. Computers not only solve the legibility problem with prescriptions, they can also remind the doctor about potential adverse drug-drug interactions or patient drug allergies, and even recommend an adjusted dose based on a patient's kidney function. In some hospitals, drug orders are bar-coded to be sure they are going to the right patient, and intravenous drugs are delivered through "smart pumps" that ensure the dose is acceptable.
Computerizing medical care will be expensive, but there should be a huge return on investment. An authoritative study from the Center for IT Leadership estimates savings at a staggering $78 billion a year just from better information exchange. If not done properly, computerizing medical care can frustrate doctors and threaten the confidentiality of patient records. But in health-care systems that have adopted the technology, these are occasional problems, while improved safety, quality and efficiency are a daily reality.
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By David W. Bates, M.D. and Anthony L. Komaroff, M.D.
Bates and Komaroff are professors at Harvard Medical School and Brigham and Women's Hospital. For more information go to health.harvard.edu.
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