It’s five years since the ARRA/HITECH legislation was passed that pretty much mandates that American medicine has to computerize. Policies created since then have been enormously effective at moving adoption forward. We still need vast improvements of the user interface, but things are moving in the right direction.
Five years ago I myself was trying to figure out what to say about the garbage I’d discovered in my own medical record – actually the garbage was in my insurance billing history. That period on this blog was full of explosions. The uproar led my wife to post this on April 5, 2009. It’s worth revisiting.
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From my wife:
I truly don’t understand why human medicine finds it is so difficult to put medical records on the computer. Veterinary medicine has had that ability at least for the last 10-15 years.
An example is the Idexx Cornerstone Veterinary Practice Management software that has easy to use programs and imports lab data directly from the company or your own in house laboratory machines.
Another example is Banfield, The Pet Hospital, who collects data from all its hospitals around the country and anonymously collates the data. Systems like this allow early detection of things like disease trends, vaccine failure and new disease processes. IMPORTANT information.
I’ve been told the VA healthcare system has had similar abilities for some time too.
We don’t even have to start from scratch on software like this for humans, just update or modify systems already created.
Signed, angry veterinarian, Virginia Rambow, DVM
Here’s what she’s talking about, from Banfield’s page on evidence-based medicine:
our centralized medical database is the most comprehensive of its kind. It allows us to electronically gather and access millions of Pet records. With this tool, our team members are able to stay informed and up-to-date in the practice of evidence based medicine. In addition, this technology enables us to conduct quality-assured, cost-effective clinical studies to facilitate the continual improvement of Pet health care.”
My goodness, and all this at the price of a veterinarian instead of a human doctor?
Now let’s hear all the vastly complex reasons why what she proposes can’t be done.
Follow the money and the politics. Both factors needlessly impede progress in Health IT, worldwide, with few exceptions. We cannot eliminate them, but we can strongly influence them.
The power of patient involvement needs to extend far beyond management of one’s own record. We need to create a new social norm in which health care knowledge is expected to be freely shared with educated consumers, and lack of sharing is sanctioned. This requires significant changes education of both consumers and care providers, mirroring what’s needed to manage one’s finances, nutrition, household, and other day-to-day living.
I look forward to the day when the e-patient experience is typical, not exceptional.