Demystifying Medicine One Month at a Time

Tag: informatics

Carrots & Sticks

Depending on your viewpoint (and the pertinent issue), government regulation either:

  1. snarls the wheels of commerce and chokes American competitiveness OR
  2. enables us to live productive, happy, equitable and safe lives. [As Oprah says, “Live your best life…”]

Medicine is full of regulations. For the most part, this is good. Certification and licensure of doctors means that there’s an explicit level of vetting and trust that a patient can bring to any encounter.  Agencies like the FDA test and certify the safety of medications and devices for the public’s good. Controversy abounds in its decisions, but for the most part the agency is looking out for us.

The computer mouse fairy?

Which brings me to medical records.

For hundreds of years, medical records were inscribed on paper, and locked away inside health care institutions and doctors’ offices. With the advent of computers, it made sense to keep these records electronically. For one thing, this saves paper and space. And now your doctor’s crappy handwriting is less of an issue–for you, the insurance company, or the pharmacist.

In theory, the computers (servers, really) housing electronic medical records could be connected for purposes of data sharing (epidemiology) and research. Moreover, if you are enabled to view your own records and lab results online, you (well, let’s say the average patient) might be more inclined to take initiative with regard to your own health. Such opportunities would make the doctor-patient relationship much more of a two way street.

Whose information is it really, anyway? Does it belong to you or your doctor (or your HMO or medical home or “provider” or whatever you want to call it…)?

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Paging Dr. Dilbert

I always thought being a doctor I’d be free from cubicle life.

Not so.

Our medical center spent more than sixty million dollars over the last six years to upgrade the computer system we use.

It’s a system we use for just about everything.

With it, we can admit and discharge patients, write orders for the tests and medications they need while they’re in the hospital, and even do most of the documentation and charting for their stay. (Interestingly, though nurses, therapists, and virtually everyone else uses the computer for charting, we doctors still handwrite our progress notes and put them in a paper chart.)

I’m no Luddite, and generally I’ve been happy with the transformation of our systems.  The upgrade is in line with the federal government’s push to digitize all things medical to improve efficiency, safety, and ideally, lower health care costs. Medicine is finally moving (like most other industries before it) into the 21st century.

Be careful what you wish for.  Mandates bring all sorts of unintended consequences.

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