Wednesday, April 22, 2009

What Happened to My Medical File?

By Angelo Bouselli, Communications Manager, FasterCures
Images of my mother taking me to the doctor in a small town just outside of Scranton, Pennsylvania as a kid in the 1970s flicker in my mind like an old science fiction movie – the women behind the sliding glass window, the ugly chairs in the waiting room, the bright lights, and playing with Matchbox cars. We would wait to be called, walk through that heavy door with the little window, and down a long hallway lined with endless shelves of paper files. As a kid it was all very foreign to me but I knew those folders were somehow important.

I recently had a full physical with my doctor of 11 years. Until this visit, I hardly paid attention to what my doctor was writing in my file. As with every routine exam, he started asking questions. I knew the answers to some, but others he had to help me figure it out. He opened the folder and leafed through pages that should contain my life’s medical history – but he only had the chapters from the last 11 years. The rest of my story is probably stored in a box somewhere in northeast Pennsylvania.

What will it take for me to have a folder with my entire medical history? And, who should bear the responsibility of managing my record? Should I take it upon myself to keep this folder updated? Should I count on my doctors to keep each other appraised? Should I expect some government agency to bear this responsibility? And if I or some other entity were to go through the process of putting all this information in one place, then shouldn't this information be made available to clinical research as well?

In this day and age, we need a system that houses our complete medical record, the same way my bank managers my financial history. And, this system should be accessible by those we turn to deliver medical care as well as those we count on to develop medical cures. My current paper file is useless to me should I need medical care outside of my doctor’s office. Despite years and millions of dollars invested by government agencies and private IT companies to spur adoption, less than 20 percent of physicians currently use electronic health records. A recent survey from the American Academy of Family Physicians identified start-up cost to be a major barrier for providers to purchase an electronic system.

The Congressional Budget Office estimates that of the $787 billion stimulus package Congress approved in February, more than $20 billion will be spent on health-information technology between 2011 and 2015. A comprehensive health IT system is a giant step to making healthcare more efficient. I hope these stimulus dollars stimulate health providers nationwide to go paperless, save some trees, and most importantly deliver more effective and efficient care.While I’m still interested in finding out where the first 20 plus years of my medical history is, I’m more interested in knowing how the $20 billion will actually stimulate health IT adoption. Will my doctor in Washington get his share of the $20 billion pie? What about my doctor in Pennsylvania? And, what of those working in the labs to develop new medical treatments – do they get to benefit from the health IT movement as well?

For more information on EHRs download a copy of the FasterCures report "Think Research: Using Electronic Health Records to Bridge Patient Care and Research"


pfj said...

Your message, and memories, make me think of several things.

First - from my personal experience - even when medical records are readily available to the DOCTOR, he (or sometimes she) seems to feel that they are his personal property. Not yours.

I see this as a huge, not-much-discussed problem. Of course my feeling is that they are MINE, and that he is entitled to a copy. Big difference of opinion.

Second - I have wondered if people could have a "thumb drive" or "jump drive" or whatever you call it, with their copy of their medical records? Take it to any appointment with any doctor or healthcare provider.

Even people who are not computer-literate could carry it back and forth.

I can imagine just as many problems with this idea, as with any other. Of course; everything has associated risks, problems and unintended consequences.

One fear might be that people would lose them, or be careless with them. Seems very similar to the key to a safe deposit box. Some kind of strong password system should be needed; and yes, thieves and clever folks can cause all kinds of damage.

But if that were available to me, I'd take it in a New York minute.

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