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Description: The goal is to improve health care and to reduce its long-term expense by moving the doctors and hospitals from ink and paper into the computer age — through a shift to digital patient records.

Source: NYTimes.com

Date: Feb 26, 2011

The long-range vision is that computerized patient data is a step toward what health care specialists call a “learning health system.” That means data across populations of patients can be analyzed to find what treatments are most effective or to get early warnings on dangerous drug interactions.

“Islands” of such learning networks already exist, notes Charles P. Friedman, chief scientist in the federal health information technology office. By mining its patient data, Kaiser, for example, was first to identify a link between the pain-relief drug Vioxx and a higher risk of heart failure, well before Merck pulled the drug off the market in 2004.

Yet the road to a national computer-enabled learning system, specialists agree, promises to be long. A major obstacle is that so many doctors, especially in small practices, are leery of technology they see as needlessly hard to use and time-consuming. “Doctors don’t want to become clerks,” says Dr. Isaac Kohane, a health technology specialist at the Harvard Medical School. Read rest of story

Questions for discussion:

  • What are the benefits of digitizing medical records ?
  • Could theses benefits be relized in Canada’s versin of health care?
  • Why hasn’t the medical industry moved to this digitized model of helath care before now?

23 Responses to “Carrots, Sticks and Digital Health Records”

  1. Mark McKee

    I agree with the movement to make all medical records digital. If they can organize the information in an advanced data program that can analyze the data to predict what treatments are best for patients this will have an enormous effect on the heath care system. The article mentions that hospitals in the US do not view themselves as partners but competitors. So they are apprehensive about sharing information with other institutions. But with the reform of US health care system this may change things. On the other hand the Canadian health care system is funded by the government. If this digital medical records system was to advance in Canada we may have less of a problem sharing information due to a less competitive atmosphere. I think it is all a matter of time before all information will be digital because computers continue to be more and more advanced and will get better at organizing information for our medical benefit.

  2. Oloff Dreyer

    I believe there are many benefits of digitizing medical records not only for convenience but for ease of access by doctors and physicians to diagnose a patient with greater ease and efficiency and that can save lives. I believe these benefits can be realized in systems such as Canada and believe to some degree have been realized in the form of systems such as Health Link. The doctors seem to have greater efficiency at diagnosing patients and problems associated with them. Although this sounds great, some problems may arise as some disorders take more than a patients past history to diagnose. In many instances the fact is that the doctor will have to do their own research and tests to discover treatment options and solutions without rushing to a conclusion. I think the reason that the insustry had not moved in this direction earlier is because as with any new system, bugs have to be discovered once on the market and solutions have to be found. No one wants to be the one who takes the dive and realizes that they spent a couple million on a system that only adequetely does the job proposed.

  3. Brett Quinton

    I feel that the benefits of digital records outweigh the costs. As a society we seem to be resistant to technological change. It is as if the world is going end every time a change is proposed. I think that in order to stay competitive a hospital needs to have access to digital records. The Canadian system of health care has already spent a lot of money trying to ensure that all records are digitized and that they are accessible in cases such as the ER. This provides the ER physician enormous benefits as they know instantly what the patient is allergic to, what their past conditions are and what medications they are taking, even if the patient is not conscious. This takes away the guess work and could save many more lives than the current situation of guessing what could be wrong with the patient. The downside is that is costs money and requires people who are set in their ways to change. I feel that in 30 years when the people who are afraid of computers and change are retired this process, and future technological changes will happen much more quickly than they do now.

  4. Kevin Beauchamp

    From a broader scope, digitalizing medical records seems like a no-brainer. It leads to covienent information that can help discover adverse drug interactions faster, provide suggestions for treatment based on previous patients, and help with research leads to the cure of some major diseases. It could certainly be viable in the Canadian version of health care as it would go a long way to saving lives. The main negative factor that is involved is the costs of it. Not only does the technology cost a lot by itself, but it has to be installed perfectly due to the need for precise results in the medical sector. It hasn’t be fully implemented as some small practices simply can’t afford to spend money on the extra benefits it provides. Hopefully over time as more effective and efficient methods are developed for digitalizing medical records, it will become commonplace in the majority of hospitals.

  5. Corey Bedard

    Digitizing medical records has an immeasurable amount of upside. The number of fatalities that could be avoided simply by knowing what allergies an identification bearing patient who is incapable of speech and is on vacation away from their hometown is without a doubt a great enough number to warrant a computerized medical record system. In a world overrun by technology, to have something so drastic as a person’s life in danger because of, what could be called, a lack of technology, is an outrage. The Canadian healthcare system could realize these benefits as much as any other system. Hopefully, in the near future this proposition of digitizing medical records is implemented, as it could only be received as a good thing. Something tells me that we are not far off of this technology and that one day there may just be an app for that.

  6. Warren

    Digitizing medical records can only speed the process of treatment. It seems like a huge undertaking know, but could be easier to maintain and update better than pen and paper ever could. For example, smaller town hospitals can send information to larger centers to small town residents that need emergency treatment in a larger center that has full services. A potential collaborative relationship could really benefit patients. This efficiency could help speed up the process and ensure people are given quality treatment efficiently.
    Digitized health records would be a tremendous cost to implement. Of course I could see how marketing companies would want this information for future information into pharmaceuticals and other health products. If your health is number one it should not be seen by other eyes. The doctor patient confidentiality oath should be honoured. Health is a sensitive and private subject for some. The records must be protected from any malicious hackers to purposefully sabotage the system only putting the health system further behind.

  7. Caley Sinclair

    Digitizing medical records will have many benefits for the future. Patients will have less sufference due to medical errors. There is fast access to medical support and the records are kept in an order than it organized as well as presented in a way for others to understand it better. It could also list instructions for physicians to follow when treating certain patients. the records would also be much more mobile and connected to other electronic medical systems. Overall, these records would be much easier to access and could follow patients wherever they go. There would be no lag time between doctors learning history of new patients.

  8. Wendy Rivers

    I agree with the movement to make all medical records digital because there are many benefits that will outweigh the costs. Digitizing medical records will speed the process of treatment and diagnosing patients. Doctors will be able to diagnose a patient with greater ease and efficiency which may allow the doctors to speed up the treatment which could save the patients’ lives. This will occur because doctors will know instantly what medication the patient is allergic to, what medications they are currently taking and their past medical conditions. The main negative factor that is involved is the overall costs of the hardware/software needed. Another negative factor for having digital medical records is that some problems or health conditions that occur may not be a result of the patient’s medical history. And the doctors may focus on connecting the dots with current symptoms with the medical history which could affect the patient’s wellbeing.

  9. J.E.

    Digitizing records is something that has needed to be done a long time ago. Something as sensitive as somebody’s health records should be stored in the most secure way possible and I believe that digitizing would do this. I am not sure why Canada has not done this yet but maybe once they see how it works in the United States (and my guess would be very well) then they may be more inclined to bring it up here. I myself would prefer my records to be stored digitally and also think it would save vast amounts of time. I do however love our health care system in Canada and like how it is not all a competition for your business like this article put it in the States. All in all digitizing may at first seem like too large of a cost to incur but once the initial transferring stage from analog to digital is made it will most definitely speed things up (plus then the doctor can just Google your symptoms in front of you now instead of having to leave the room) 😉

  10. Kendra

    There are obvious benefits of digitizing medical records. Easy and quick access to records especially in times of an emergency, is a definite plus. These digitalized systems could be used to check family history as well, not everyone knows who in their family has had which disease, this could help with diagnoses. What I’m not to sure of is how FOIP will be affected. Especially since the aims of this digitizing trend would be towards information sharing between hospitals. The easy accessibility of information makes me leery, but in theory this could be a very valuable alteration of the way medical information is being recorded and stored.
    Monetary considerations are probably the number 1 reason why canadian hospitals have not adopted these systems yet. Something that I think may have also been a consideration is the fact that systems are difficult to keep 100% secure due to hackers. I can see how the medical industry hasn’t enthusiastically adopted digitalized medical records.
    Hopefully the push towards computerized medical records comes with some thought about systems safeguarding to ensure confidentiality and measures to protect from the misuse of people with authorization to use such systems. If an appropriate level of thought and planning occurs, the potential benefits of digitalizing records are endless.

  11. Rob C

    The switch from manual paper info to digital health records would definitely be a wise way to go for the American medical system. Especially with monitoring different trends among patients the benefit of digitizing medical records can give them an overall overview analysis on different areas in regards to patients and their progression or regression.

    These benefits could also be realized in Canada, but I think that digitizing medical records has not occurred prior to now because it is a large expense that would create additional costs for the medical industry and thus take additional money out of the pockets of the industry`s CEOs.

  12. Kim Berger

    Yes, these benefits could be realized with the Canadian Health System. In some parts of Canada the change from manual record keeping to electronic record keeping is already under way. As with the US, there are incentives in the Canadian system too, but not to the extent of 27 billion dollars worth. It makes so much more sense to implement this system than to stick with the archaic outdated version of trying to manually record and locate each health record with each new patient and visit. We do need to implement this system fully for the benefits it provides to each user of the health care system, but that being said, it is no small task. It will take a whole lot of time, money, and effort, and there is no way around this, but in the end, we will be better off for it.

  13. Kuda

    The benefits of digitizing medical records would be that there would be consistent patient information concerning their illnesses, allergies, and general conditions that would likely reduce errors in diagnoses. Such information would mean that the records from childhood up to date would all be available. Digitizing medical records could be helpful in assessing the effectiveness of particular drugs over time. Generally, like many computer based systems, digitizing health records is likely to improve efficiencies as necessary information is available. However, the effectiveness of such a system can only be realized if there is collaborative system in place that allows for Doctors to share patient information. Although I am not familiar with the Canadian context of health care, digitization would be a welcome improvement within the medical field. Seeing that in Alberta many have Alberta healthcare it would be easier to start form there when allowing for digitization of records in that these records are attached to the Alberta Health care number. Failure to implement it might be as a result of the process in place of assessing its usefulness.

  14. Jolan Naismith

    Why would digitizing medical records be any different from any other technological change? It has both benefits and potential issues, however I believe that over a short period of time the benefits will far out weigh the issues. Having medical records on hand will inevitably speed up emergency room wait times, as well as increase the doctors ability to make a more informed decision regarding a patients past, present and future health. Patients in emergency room settings can be stressed and in shock decreasing their ability to recall details from their medical past that may have significant baring on their current health situation. Medical records becoming digitized will increase hospital efficiency, and effectiveness and help decrease the economic burden on society that too many tests are performed in our current hurry up and wait medical system. Yes it will take time to train medical professionals to use this new technology, however I am confident that some of the most intelligent people in our society who can figure out what is wrong with the human body can point and click with a little practice.

  15. Nyle Watts

    The uses of these digital records in hospitals and clinics seem to be only beneficial, both for the doctors and for the patients. There are two scenarios in particular that this could be useful: First, if you had a heart attack or stroke while you are at work or somewhere outside home and were taken into emergency with no family member accompanying you, you obviously would not be able to communicate what sort of medications/medical conditions you have. Having a digital record of what medications you are on and having easily accessible for doctors could make treating you faster and thus save your life quicker. Second, when you go to the clinic and the doctor asks you if you are on any medication, instead of bringing all your medication bottles to the clinic in a plastic bag, the doctor could just look at your medical records to see all the medications you’re on. The doctors would be able to make diagnoses easier, and prescribe medication that could help you and not interfere with any of the other medications you are currently on.

  16. Ashley H

    Benefits of digitizing health care records discussed in the article were that ”doctors have more complete information in treating patients, reducing the chances of medical errors and unneeded tests”, “…to improve health care and to reduce its long-term expense by moving the doctors and hospitals from ink and paper into the computer age”, and it’s a “driving change through the system will involve shifts in technology, economic incentives and the culture of health care”. It would also create many jobs, which would be greatly beneficial for the States with their economic situation. I think the benefits outweigh the costs in the long run. A decrease in “medical errors and unneeded tests” can cut down on many medical expenses. It would also make it challenging for people to abuse the system; going from doctor to doctor getting similar medications such as painkillers. This new technology most likely has not been introduced to the health care industry before because of how costly it would be to digitalize all medical records.

  17. Teigen C.

    I think that this needs to be done and should have been done a long time ago! Hospitals and medical offices are one of the last places to advance into the computer technologies. In my opinion, it’s about time! Computerized records would definitely decrease any errors and I think that alone is a reason to convert. Instead of being the last ones, hospitals should be the first to jump on any new technologies because they are the ones that have people’s lives in their hands. Anything to make their job easier, and more effective should be done. I agree with previous posts that the benefits greatly outweigh the costs.

  18. Katelynne Swenson

    To move to digitized records in Canada would be costly and time consuming. It has already been started however. I personally feel that it is a good idea for Canada to move into a more technological system. Using digitized health records would be much more efficient in the long run, as well as easier to move across systems. Everything would be much more organized and easier to locate once it has all been digitalized. This system will take many, many years to fully become effective. Employees will need to be trained in the new system for it to fully work. I think that it can only be used for newer, younger patients however. To implement digital records all at once would be too costly. It would therefore take many years to fully implement the system, but it the long run I think that it would be very worth it for Canada.

  19. A.S.

    There are many benefits in digitizing medical records. One example is how doctors will have more complete information in treating patients, reducing the chances of medical errors and unneeded tests. It would also be beneficial in transferring a patients medical records electronically, if say they were out of the country. For example, during the Fall semester I was on an exchange in South East Asia. Near the end of it, I had encountered a serious foot infection, in which I had to visit a clinic. Because I was a new patient, they did not have any medical records on file and any relevant information was all in ink. But with this digitized system, my medical profile could have been sent via electronically so the doctor would have access to my medical history and other valuable information in order to assess the right kind of antibiotics to treat my infection.
    This trend could definitely be realized in Canada’s version of health care, only costs of implementation would be staggering, resulting in increases in health care insurance premiums. However, there is also the possibility of government assistance programs to aid some of these incurring costs.

  20. mike

    Digitizing medical records could have many significant benefits. Doctors would be able to reference symptoms for uncommon diseases and recommend proper treatments. They would be able to create a large database that would compare different treatments and monitor results, side effects, etc more quickly and easily. Also, you would be able to transfer patients records from one medical institution to another, so the doctors would have all the necessary information of your chart to make correct decisions when diagnosing problems and suggesting treatments. If patients forget certain conditions they have, ie Alzheimers, or cant talk to the medical staff (unconscious or coma) the medical staff could still retrieve their information. This would also make it unnecessary to fill out forms every time you visit a new medical facility. Doctors could also retrieve family history of conditions (risk of heart disease, etc). One problem with the system may be patient confidentiality. If the information was available digitally, there are so many people in the medical field that could have access to the data and use it unethically. The data could also be at risk of falling in to the hands of hackers.

  21. Megan

    The main issue of implementing such a system seems to be the ineffective results that small practices would see. The probable reason that this type of system hasn’t been introduced before now is the lack of usability it harbors so far. One day when the technology has been modified and improved so that small practices could also benefit from it, that will be the best time to implement the technology. There are many obvious benefits to a system like this, and for all we know, other benefits that have yet to be realized. Unfortunately, it will probably end up causing more headaches than it relieves for some users; mistakes are likely if the technology isn’t working for everyone, therefore waiting awhile while the details get ironed out may not be the worst idea. The only other problem that could be a reason why the technology isn’t out yet is the cost. If the USA uses Medicare to their advantage, small practices may be able to get their equipment paid for in the long run. There are plenty of scenarios that see this technology working out, and I hope it does.

  22. N.P

    I think that digitizing medical records can be very beneficial because doctors would be able to easily transfer a patients medical records to any other doctor by a simple click. These files can be easily transferable to anywhere in the world. One of my concerns would be about incorrect data being inserted into a patients file, inconsistent reports, loss of information. Without written logs, how would they be able to pin point any irregular information or mistakes. Also, how much training is required for doctors and medical assistants to be able to use these devices? I think it is a great idea, however, when it comes to technology, you never know how easily it can collapse and fall.

  23. M.lee

    After reading many of the comments I have a torn opinion. There are obviously some really good benefits of digitizing medical records. Such as the availability of information, the quick access to records especially in times of an emergency. These digitalized systems could be used to check family history as diagnoses people that may be unaware of family history. But then I also believe that this can also be an invasion of personal privacy. If I decided not to share with my family a disease such as Alzheimer’s, a family member may be disclosed this information as it may correlate to their symptoms. The cost effectiveness seems to be overlooked; this systems upkeep would be extremely high and rapidly changing to maintain threats and errors. With such reliance if the system were to ever fail it could be deadly. The current system obviously needs change but I believe that the possibility of problems and cost out way the benefit.

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