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Yesterday the Wall Street Journal (Nov. 29, 2006, page B1) reported that a consortium of employers including Intel, Wal-Mart and British Petroleum will provide their employees with electronic medical records.  These will be available online to link with doctors’ offices, hospitals, and pharmacies, with a goal of helping consumers coordinate their own care and reduce costs.

What are these companies up to?  None is a health care company, and only Intel stands to gain much from a move to electronic medical records.  One reason is that they don’t believe the health care industry is capable of taking the critical step of making health care information available electronically – realize that health care is already 20 years behind financial services, which abandoned paper-based records long ago.  Another reason is that companies are simply tired of paying for medical mistakes, administrative waste, and duplication, which cost billions every year.

Why should we care?  We all have a lot to gain.  Right now most of your medical information is on pieces of paper somewhere in your physician’s office where it may be lost, misplaced, or unavailable at your next visit.  That information will be viewed for a few seconds before your physician comes to see you for your next office visit, but it is otherwise unavailable when it is most needed.

There are four reasons why the move to electronic medical records is a critical step in improving health care:

1. Safety.  Hospitals kill at least 98,000 patients each year through avoidable medical errors.  Most of these deaths could be prevented if your medical information were available in an electronic format that would allow automatic checks to make sure you did not get the wrong medication or treatment.
2. Efficiency.  Banks gave up on passbooks twenty years ago because they were inefficient, error-prone, and expensive.   We still use the same technology to manage your health care.  Estimates for the potential savings range up to hundreds of billions of dollars – enough to cover the uninsured.
3. Quality.  It would be easy to upload what we know about the best medical care, and then check your medical records whenever you touched the medical system to make sure that everything that would help you was being done.  This is especially true for preventive care, which is much less expensive than treating established illness.  It would also help identify which medications and treatments were most effective, because the results of the real-life experiences of millions of individuals would be available to analyze.  Right now many medical "best practices" rely on  prejudices and untested beliefs.
4.  Control.  If you had all your medical information at your fingertips, you would control the care you received.  It would be easy to get a second opinion, to find the best surgeon or hospital for a procedure, and to consult experts on the best course of treatment.  It would also be much easier to compare costs and find less expensive ways to get better results.  You can see how this threatens the current medical industry.

While the Veterans Administration and Kaiser Permanente have received well-earned attention for their efforts to bring medical information online, the healthcare industry as a whole has been slow and resistant to taking this step.  It is shameful that it takes employers getting fed up at paying for injury, waste and mistakes to drive the adoption of technology for better health care. 

Baseline Magazine takes a look at the English government’s health-care information system overhaul, showing us just how complicated and expensive health-care technology can get.

In 2002, the English government embarked on a $12 billion effort to transform its health-care system with information technology. But the country’s oversight agency now puts that figure at $24 billion, and two Members of Parliament say the project is "sleepwalking toward disaster."

Read more at http://www.baselinemag.com/article2/0,1540,2058194,00.asp