The ongoing health care crisis in the US is so pervasive and yet so invisible. It is a smog you and I breathe in every day, everywhere. It is manifest on so many levels, so overwhelming that it is nearly invisible.
In primary care offices, doctors struggle to see more and more patients, many of them medically and psychologically complex. We order all manner of complex studies, and if we’ve taken advantage of a current subsidy, we record this all in electronic health records (EHRs). This subsidy, which helps pay for EHRs, is slated to turn into a penalty over the next few years, as practices that hold off on the risk of such a large purchase look to which will be worse: spending a few hundred thousand now with the promise of a rebate, or having payments withheld for failing to buy a system which may very well be obsolete in five years.
Information technology in medicine is stuck in the 1980s. Individual hospitals and practices purchase their own systems, customize them, curse, bless them and operate them as if they were simply electronic versions of paper charts. The technology has existed for decades to give every person their own comprehensive and portable health record, one that could be accessed by any health facility. Whether held in the cloud, in a USB stick, or a magnetic card, a personal health record, or even a unified national medical informatics system could save millions, perhaps billions, in unnecessary testing, treatment, waiting. It could streamline preventative care. It could help us track the real results of interventions on a population-wide level, as is commonly done in Scandinavia, England, and other industrialized nations, nations that spend less and get more for their health care Euro, Pound, or whatever.
Privacy concerns are real, outside of the paranoid rantings of various libertarians, but these problems can be minimized, and the price we are paying simply isn’t worth it.