Health care can be better than this. The technology is available to produce a comprehensive medical record which is available absolutely everywhere a patient allows it to be seen.
I don't mean an electronic medical record in just one doctor's practice or just one hospital system. I mean a complete medical record that will go from each care site a patient visits to all of his other care sites.
The credit card industry demonstrates the technical feasibility of establishing such a system for our health care. The credit card system captures information from numerous disconnected sites, coordinates it in a central location, keeps it secure and distributes it efficiently.
Of course, security, privacy and confidentiality are major concerns. The system must be protected by a first-tier data-processing company such as IBM or EDS. These companies are in the business of keeping large amounts of data safe and secure.
There is no reason to believe that a coordinated information system will be less secure than the fragmented systems that currently exist. In the 21st century, patients should have the right to control access to their personal health-care record.
An average person's medical data is scattered among at least 13 different locations. Fragmentation is a major contributor to the high incidence of misdiagnoses, inappropriate medications, duplication of tests, frequent emergency room visits, unnecessary hospitalizations and fraud. Coordinating the record would reduce these problems and improve the quality of health care that I can deliver.
When the medical record is no longer fragmented, there will also be financial savings due to the efficiency of information transfer as well as elimination of waste. It is projected that a coordinated system can actually reduce costs by 20 percent, which would save about $2.4 billion in Utah. As long as the system is designed correctly, the savings would be spread across the entire system.
Lower costs for the patients will increase the number of patients who can afford health care. Then, too, lowering health-care costs allows government programs to cover more people with the same funding. A coordinated medical record has implications for better public-health decisions as well as for the identification of what is appropriate for cost of health care.
A uniform, statewide medical record can be applied either alone or in concert with other types of reform. But it should be first. Coordinating medical records will help patients more than any other option for health-care reform.
Last December, a not-for-profit coalition of doctors and patients began organizing to establish a coordinated, patient-controlled record. This coalition is open to all individuals and businesses in the state. The larger the number of supporters who gather together, the sooner we can initiate a coordinated medical record.
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* LAUREN O. FLORENCE is a founder of Healthcare Information Initiative of Utah, HIIU.org.
