Monday, February 9, 2009

Electronic Health Records and President Obama - 7 reasons why his initiative is right

Copywrite Peter Yellowlees MD. 2009

President Obama has been widely quoted as saying that he wants the federal government to invest in electronic health records so all medical records are digitized within five years. He plans to strengthen the security and privacy governance arrangements for health information currently in place, ensure that health information cannot be sold or passed on without patient consent, and increase the range of penalties for those who do not protect health data appropriately. Hopefully there will also be serious reconsideration of introducing a national patient identifier for healthcare as part of this initiative. This healthcare initiative is essential to move the American healthcare system of care into the Information Age, and has the potential to dramatically improve the way all Americans are treated when they are sick.

It is important to look at the many positive reasons why the introduction of electronic health records is so important for Americans, and not get lost in detailed technical or philosophical debates, as tends to often be the case around this topic. There are seven areas of major gain for Americans with the introduction of a national electronic health record system:

1. We are in the Information Age, and healthcare, which is an Information Industry, needs to be modernized just like the banking, communications and media industries, and made more efficient, through the more effective use of health information. Numerous studies have demonstrated how electronic health records both reduce medical errors, and increase overall quality of care.
2. The Internet and its associated multimedia environments are here to stay. Their existence will facilitate the development of an entirely new information infrastructure for healthcare, incorporating electronic health records, and numerous other multimedia environments and analytic tools. Investments in health are likely to continuously move away from bricks and mortar to bits and bytes, and the Obama plans will kick start this approach.
3. Health consumers have already taken to using the Internet for healthcare. Approximately 10 million people in the USA search online for information about their health, or the health of their loved ones, every single day – a total of 140 million Americans have already undertaken such searches. People trust their doctors and like to discuss information they have found on the internet with them. Most health consumers already assume that much of their health information is already electronic and are increasingly accustomed to the idea of their personal information being maintained online. Major companies, such as Google and Microsoft, have illustrated this change in attitude by introducing their own personal health record systems.
4. A well introduced national health electronic information infrastructure will lead to better security and privacy than we have with our current paper records. Our present records have minimal capacity to be audited for inappropriate access by those who should not be seeing them, and are probably accessed much more than we realize.
5. Electronic health records will allow us to leverage new technologies such as virtual reality environments, telemedicine programs, multimedia applications, genetic databases and increasingly sophisticated search and decision support tools. We will certainly be using these tools routinely in future as we move increasingly to a personalized consumer focused health system, whereas at present many of these approaches are used only sporadically.
6. With the simultaneous move to some kind a national health insurance initiative, another goal of President Obama, the existence of electronic health records is simply essential to be able to provide care to the current 47 million Americans who are estimated to be uninsured.
7. Disease prevention, health promotion and chronic disease management are all essential solutions to the American healthcare crisis that need to be promoted and enhanced over the next decade. All of these approaches to care are made much more effective in the setting of good quality health information on both individuals and communities that can really only be provided electronically.

The need for national electronic health records is essential to allow us to improve the American healthcare system, and to make our healthcare services more personalized and consumer focused as we move increasingly into delivering healthcare in today’s information age. We need to support President Obama in this important initiative.

This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http:// and most online bookstores.


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  2. I strongly agree with your proposal that reconsideration of introducing a national patient identifier is key. As a practicing physician, I see many charts that are either reproduced or not found on a search because a middle initial is absent or different cultures refer to their 'last name' as their mother's maiden name.

    Creating a unique patient identifier would help reduce omission of key elements of a patient's history and prevent doctor shopping as well.

    Jonathan S. Ware, MD

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