Costco Connection - March 2008

from experts in the field:

Republican Congressman Paul Ryan serves Wisconsin’s 1st District ( www.house.gov/ryan).

FEBRUARY DEBATE RESULTS:

Should there be a national primary?

WITH TODAY’S TECHNOLOGY, there is no reason that patients and their doctors can’t have immediate access to their medical information through a nationwide network of electronic health records.

Think about the convenience and peace of mind it would provide if every time you visited a new doctor or hospital you could be

sure that your up-to-date health records traveled with you. Aside from saving you the trouble of repeatedly writing down your medical history and getting your past records transferred, it could save your life if the physicians treating you could verify at a glance which medications you are taking, which drugs have given you problems in the past and if there have been complications from past surgeries or other medical treatments. This can be especially critical during emergencies or natural disasters, such as Hurricane Katrina, when people are away from their regular health-care providers.

Not only would this reduce medical errors that could result in harmful drug interactions, but it would also help bring down the soaring cost of health care by cutting back on excess paperwork, lowering administrative costs and streamlining the reporting of public information. According to a RAND study released a few years ago, the use of electronic medical records and a nationwide health information network could save $152 billion a year.

With the proper safeguards to protect patient privacy, a system of electronic medical records can improve the security of this sensitive information, which is now kept in disparate paper and computer filing systems maintained by different doctors’ offices and medical centers. It would also help to establish standards for interoperability of information technology to enable doctors and hospitals in one part of the country to share information easily and confidentially with their counterparts in another region.

We can check our bank accounts online and use cards at ATMs, and we should have similar access to our medical records and be able to share this information with doctors and hospitals. I have co-authored bipartisan legislation—House Resolution 2991—that would make this a reality, without a costly government program or government database of patient information. C

NO

18%

YES 82%

Percentage reflects votes
received by February 11, 2008.

JANUARY DEBATE UPDATE:
Should some form of national
service be mandatory?
YES: 67% NO: 33%
Percentage reflects votes
received by January 31, 2008.

from experts in the field:

LOSS OR THEFT OF PERSONAL DATA reached record levels in 2007. So why would you want your personal medical record in an electronic database?

Would it make your medical record available if a hurricane wiped out your doctor’s office? Maybe—but you don’t need a data warehouse, just a backup of the data.

Could it save your life if you’re brought to an emergency room, unconscious and bleeding?

Not likely. Your critical medical information on a MedicAlert bracelet will provide the information more quickly.

Would it eliminate medical errors? Not if doctors trust data entered by a harried clerk or information that might have come from an identity thief’s medical history. Once errors are in an electronic database, they may be virtually impossible to expunge, thanks to multiple backup copies in multiple unknown locations.

Electronic records do not magically transfer your history into a doctor’s brain. In fact, many doctors find them a hindrance. The best way to understand a patient’s story is still to hear it directly from the patient.

Admittedly, electronic entries might save the hassle of filling out duplicate forms. But even in the computer age, we have more, not fewer, forms to fill out.

Who wants to have everyone’s health information compiled in some electronic database? Vendors of hardware and software. Companies that want to profit from targeted marketing— or from hawking the information. Government and private insurers that have a vested interest in not paying so much for medical care and do-gooders who want to monitor your behavior.

The users of the information are not likely to act in the best interest of the subjects of the information. Confidentiality would become a meaningless concept. If a record is electronic, patients should avoid telling a medical practitioner anything they wouldn’t want a blackmailer to discover. C

Jane M. Orient, M.D., is executive director of the Association of American Physicians and Surgeons ( www.aapsonline.org).

Opinions expressed are those of the individuals or organizations represented and are presented to foster discussion. Costco and The Costco Connection take no position on any Debate topic.