Saturday, January 16, 2010
I’ve been skeptical of the successful implementation of functional electronic medical or health records (EMR or HER), in the US healthcare system. Much energy in the current US health reform debate has looked to EHR as one solution to the ailments of US healthcare, and there are places in the world where it seems to work well. Taiwan is one example I’ve mentioned, and another is Denmark.
Denmark, a nation of six million people, is attributed with having the most wired healthcare system on the planet. Technology saves Danish doctors an average of 50 minutes a day worth of paper work, and their system an estimated $120 million a year. A network allows providers in different organizations to access and share patient information, paper-less prescriptions sent by computer directly to pharmacies, and telemedicine is encouraged. What does this mean for the patient? Among other things, that you may be able to send regular measurements of your lung capacity, blood pressure, blood-glucose, heart rate to your doctor via computer, without ever leaving your home.
Presumably their system also contains useful safety checks that bring attention to common mistakes, such as potentially inappropriate drug dosage or drug interaction.
So why not just take this system and copy it in the US? At least a couple of things stand in the way.
Though some claim that there would be difficulties scaling up from tiny Denmark to a geographic and population behemoth like the US, I doubt that’s a valid concern. Technology really doesn’t care whether it is linked to 10 or 1000 people, or transmitting 1 mile or 10,000 miles.
The principle roadblocks are cultural and legal. To begin with, unified healthcare is not a value, or priority, and actually frightens many Americans. Care providers may not want to be linked together, for fear of losing competitive advantage, or being second guessed. People don’t want the government, or insurance payers, to know too much about them. There is no support for creating a single unified network that could tie together the literally hundreds of electronic health records currently employed piecemeal across the nation. And in a market driven system, digital databases full of patient information are ripe for mining and commercial exploitation by industry.
The Danes also have a national, government run patient registry that helps inform them about the overall health of their population. This is something that most American’s would likely oppose on privacy grounds. “As long as you are a healthy man, you fear for your privacy,” the director of Denmark’s health information agency says, “It is when you are sick that you wish people knew what your problem was.”
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Posted by Ano Lobb at 12:04 PM