President Obama is convinced that a 20 billion dollar investment in Health IT (as is present in the house version of the recovery bill), can save money and improve care. An article entitled, "Clinical Information Technologies and Inpatient Outcomes" in the Archives of Internal Medicine supports that view by stating that hospitals with automated notes and records had fewer complications, lower mortality rates and lower costs than hospitals without the newer health information technology. I agree!
But lest you think that this technology is only positive, think about the downside of electronic records of any sort. Have you ever tried to correct a mistake in a billing record for a utility company? Electronic media never seems to die and resists change. A mistake in your medical record stating that you have a disease that you don't really have can remain forever and can be difficult to remove.
Electronic medical records have also been designed to foster physician use so they have purposely allowed for whole sections to be entered with a simgle keystroke. Why bother to write your own history when you just agree with another doctor's history? Just hit the key and it appears as your own. After all it is faster and the information is the same! Well often the information is not the same and incorrect records gets repeated over and over in multiple notes.
Privacy is perhaps most troubling as the ability of medical records to be shared by medical professionals also makes the loss of confidentiality easier.
We need updated health information technology but we need to be careful about its proper design and use.
Monday, February 9, 2009
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