Computerized Medicine

If there’s one profession that’s resisted modern methods of record keeping (aka, computers) it’s the medical profession.

Despite the fact that we can complete our taxes and perform complex financial transactions digitally over the Internet, medical records have faced an impasse preventing a transition to the digital age. Patient charts are still paper-based in most doctors’ offices across the country.

Perhaps that’s not surprising, given the conflict between people’s expectations of privacy (and their right to it!) and the benefits of quick, easy access to information inherent in computerized databases. Even so, adoption of 21st century methods seems terribly slow when it comes to both hospitals and doctor’s offices, and there’s evidence that the costs have been high.

The New England Journal of Medicine recently found that only 13% of physicians had made the transition to an electronic record system. The primary reason is financial. Upfront costs – which include purchasing servers, computers and software – can be as high as $36,000 per physician.
In addition, the learning curve for these programs is steep, increasing the amount of time a physician spends per patient.

Heavy costs for a general practitioner to bear. The situation is actually a little worse than that, given that the technology is far from offering a “rich user experience”. The series of “yes/no” questions that are supposed to be designed to efficiently aid in the diagnosis of specific ailments are more of a hindrance. They’re rather like the telephone answering systems that offer you a list of options from a menu, none of which address your immediate concerns or answer your questions. Worse, there are several medical record keeping systems out there, and they don’t all intercommunicate. Worse yet is the fact that inaccurate and downright wrong information is forever, as far as computers are concerned.

There’s no solution offered, of course, and I certainly can’t think of one. The only thing to do is to stick to what computers do best – maintain and distribute the information – and strongly encourage (as a matter of public policy) intercommunication between the facilities that keep and use the records, with all due consideration given to privacy concerns. Leave the human factor (that is, doctors talking to patients face to face) in the loop (I’ll argue that this needs to be enhanced at all levels). Continue to ask the question: “Does the AMA help or hinder in this regard”?

Thanks to  Real Clear Politics for the original link.

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2 Comments on “Computerized Medicine”

  1. Paul Says:

    This is an issue of data complexity, not data storage. The paper medical chart has sufficed for so long because it is a repository of very complex data, nothing more. The ability to replicate this within a computer system is hindered solely by that complexity. Solve that problem and paper will become electronic bits.

    Having discussed this with my doctor friend, cost is not really the issue here. Being able to convey the patient problem within the restrictions of the computer program is the problem. Paper is still less restrictive.

    BBD

  2. joe Says:

    I agree that storage is not the problem. I think communication – the lack of it – is. Paper is less restrictive, but only sometimes, isn’t it? I mean, would you really prefer to write to your doctor, rather than see him face to face?

    OK, that wasn’t fair, but the point I wanted to make is that the medical industry is not moving strongly to the computerization of records, and that has some serious negative consequences for patient care (most often when doctors work in teams or in tandem). Just as clearly, the computerization of medical records has caused other – sometimes serious – problems.

    Costs may not be an issue here (and I hope it isn’t to the doctors). But according to the USA Today article I quoted, it seems to be a consideration! Surprised me to read that, too.


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