Paper medical records suck. You and I have known this for a long time. But it’s confirmed this month in “Wired,” which has a cover story called, “Why Things Suck! 33 Things That Drive Us Crazy.”
Among them is this entry:
Why Things Suck: Medical Records
By Erin Biba Email 01.18.08 | 6:00 PM
Most medical records are about as orderly as an ER on Saturday night. Because they’re mainly confined to paper, they can’t be easily transferred from one physician or hospital to another. And because they’re not subject to any standards (or even legibility requirements), they’re nearly impossible to compare and combine.
Improving the system is possible, but it would take the cooperation of a bunch of interest groups that have no interest in working together. The Health Insurance Portability and Accountability Act, passed by the federal government in 1996, was supposed to fix things, but massive lobbying turned it into porridge. For example, HIPAA lets states make their own rules; now some states say doctors should keep records for 20 years, some for two.
You’d think electronic records would solve the problem, but no. Because the software vendors selling electronic record-keeping systems are competing, their systems are proprietary and incompatible. Oddly, that’s OK with many physicians. Another name for an all-knowing, all-seeing, all-compatible electronic system is database, and physicians don’t want people mining theirs — not because of patient-privacy concerns, but because the info could be used for doctor-on-doctor performance stats. Plus, docs already hate filling out charts; you think they want to learn data entry?
A fix may be on the way. Google and Microsoft are both working on software that will appeal to physicians and patients alike. (Kind of gives new meaning to “blue screen of death,” don’t it?) But a word of advice: Pressure your docs into accepting a more transparent system. If you don’t understand your chart, ask. You want some surgeon to cut the wrong leg off of you someday?
So finally a publication that fancies itself as cutting-edge gets it. Are Microsoft and Google the fix? Well, that remains to be seen. Last week, Microsoft re-branded its healthcare products as Amalga, replacing the Azyxxi and Hospital 2000 names. Today, the Redmond Empire announced plans to publish the source code for HealthVault XML interface protocols and other open-source projects.
HealthVault chief architect Sean Nolan explains the open-source initiative on his blog. Michael Zimmer, the 2007-08 Microsoft Resident Fellow at Yale Law School’s Information Society Project talks about some of the privacy issues HealthVault is trying to address on his blog today, while open-source guru and Microsoft critic Fred Trotter cautiously lauds Zimmer for a fair assessment of the issues.
As for Google, CEO Eric Schmidt is delivering a keynote at next week’s HIMSS conference, and actually is holding a 30-minute press conference afterwards. The Internet search giant also is throwing a cocktail party next Tuesday, with the theme, “Home is Where the Heart Is.” The invite says, “Come meet the health team at Google and learn more about what we’re working on.” About all I expect to learn from the secretive company is who actually works for Google (I know a couple of people already) and whether the bartender can mix a dry vodka martini.
Back to the “Wired” spread. Medical records are not the only “things that suck” in healthcare. The list also includes prescription drugs, hearing aids, infertility treatments and knees and backs, not to mention the all-encompassing science itself.
I can’t say for certain that personal health records suck, but that could be an addition to the list if someone doesn’t figure out a way to make someone other than health plans use them. You may recall that back in December I declared a personal moratorium on PHR stories until I saw proof that doctors and patients were actually using PHRs in any sort of volume.
After I got a pitch from one payer-owned PHR vendor on Jan. 29, I wrote back with a terse, “I’m not doing any more PHR stories until someone shows me evidence that more than a handful of patients and doctors are actually using the things.” I’m still awaiting a response.