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.
MARCH 2008 The Costco Connection 15