Medical Records

As part of being alive, most of us have had some contact with the medical profession and institutions. I have been around long enough to have seen many changes in medical technology. One area that seems to drag slowly behind in the US is electronic standardized medical records. As a long time computer technologist, it seems a natural progression. So why is it taking so long.

I have seen the advantages of electronic records and standardization in the very conservative financial industry. Transactions are defined by an international standard and you can send funds and other financial information almost anywhere in the world very quickly. The process is automated and even has the common term of Straight Through Processing.

Recently, I have experienced the transition from paper records to electronic records in some of my Doctors offices. In one office after about 4 months of pain during the transition, the office went from 45 or more minute waiting time in the reception area to about 5 minutes. All due to gains in efficiency. I have not experienced any loss in quality, in fact the visits seem a bit more relaxed and personal.

So why do some offices show so much resistance. I observe fear. I have talked to some Doctors about it and have seen the fear in their eyes. Fear of change. Fear of the cost to convert and maintain the new system. Fear of the pain during the transition as the staff and patience adjust to the change. Fear of lowering the quality of care. Mostly just a fear of the unknown.

But we do have some real world examples. Back in the late 1990s, Denmark starting converting to an National online medical records system so we have well over a decade of data from it.

The Danish system reports an average of 50 minute a day per Doctor reduction in administrative work. With a population of 5.5 million, it has saved the equivelent of $120 Million a year. Translate those saving to the US population and that is almost $7 billion each year.

We in the US spend a lot of money to provide a high quality of care. Health care in the US costs $7,290 per person (16% of GDP). While in Denmark it is $3,362 per person (9.8% of GDP). But what does that buy us? Life expectancy in the US is 78.1 and in Denmark it is 78.6, not any significant difference.

To get the full value from electronic records, it must be standardized, portable and accessible by appropriate medical providers.

Imagine being unconscious in an ambulance. In the current system, no one know what medications you are on or conditions you have requiring special care, unless you carry that information all the time. How many of us do that. Being able to access your history would allow the best cars in the shortest time.

Imagine the data mining applications to help improve the medical industry once we have built up a few years of records.

I see two points to push for this situation. One, lobby every Doctor office to implement an electronic records system. Two, push for a standard at the National (or even better international) level to allow for seamless exchange.