By Francis D. “Doug” Tuggle
Imagine this scenario: one night, you get a call that your wife and son, returning from a lacrosse game, were severely injured in a crash on the San Diego (I-405) Freeway.
They were rushed, unconscious, to a nearby hospital, where their personal electronic medical records revealed they both have strong allergies to conventional anesthetic. So the hospital used a substitute anesthetic, and both wife and son are on the road to a full
recovery.
Now consider an alternative scenario: It’s same as the first one, but the personal electronic medical records for your wife and son were in a format incompatible with the one used by the hospital that received them. So the allergy to the anesthetic was not identified, and they both went into comas and died.
Here’s a third scenario for your consideration: Your wife and son are just fine, no crash on the freeway. But one evening, you get a call from a pharmaceutical manufacturer who tells you they have carefully examined the personal electronic medical records of your wife and son and have discovered that there is a genetic abnormality that predisposes both your wife and son to a severe, possibly fatal, allergic reaction to a commonly used anesthetic. Luckily for them, the pharmaceutical manufacturer sells medicine that “almost always” mitigates against such reactions,medicine that has to be taken daily.
Unfortunately for you, the manufacturer cannot guarantee 100% success, and the
medicine is not on the approved list for your group health provider. It will cost you
$2,000 out of pocket each month to supply medicine to them.
The phone call has you wondering what “almost always” means, if it’s worth the extra money to protect them, if you can afford this extra protection and how the pharmaceutical company got their medical records in the first place.
(Increasingly, data are stored in the “cloud,” i.e., the Internet. Privacy protection is questionable,even the federal government had top secret data about new jet fighters stolen. Regularly, there are reports of stores having their customer and credit card data stolen. Experts agree that data storage in the “cloud” is even more vulnerable.)
One more scenario: This time, it’s your group health provider. It, too, has been examining the personal electronic medical records of your wife and son, and it, too, has detected the genetic abnormality. Unfortunately, they have deemed this an “undisclosed pre-existing condition,” and they are sorry to report that they are therefore denying coverage to your wife and son under the terms of their contract.
Worried yet?
The Obama administration is dangling around $20 billion to hospitals, healthcare providers and doctors to adopt electronic medical records and in particular electronic personal health records. 2011 seems to be the target.
The administration is touting the benefits depicted in the first scenario. Additionally, it touts that each of us could carry around our complete medical records, including X-rays, medicines taken and being taken, magnetic resonance imaging scans, records of shots received, etc.
But, there is no one format for personal electronic medical records. The Certification Commission for Healthcare Information Technology has been approving alternative formats, and still other formats are available from Google Inc. and Microsoft Corp., among others. Record format incompatibility is a real concern. It is the software version of trying to use a floppy diskette by sticking it in a CD drive.
Security and privacy have been secondary considerations to the developers of personal electronic medical records, and who can see your records and under what circumstances are unclear as of today. But privacy is a real concern that needs to be considered.
Today, some 5% of doctors and some 25% to 35% of all hospitals have adopted, or are in the process of rolling out, some form of electronic medical records, including personal health records.
But the medical community is deeply divided on their benefits and utility. The New England Journal of Medicine says that more than a third of all physicians are actively resisting the use of electronic health records. A recent study published in the Archives of Internal Medicine reports that computerized physician order entry systems can cause errors that pose patient safety concerns. There are isolated reports from employees that say that when the power went out, their hospitals lost all access to patient electronic records. Canada has been at this game since 2000, and the report is they’ve only made 5% progress.
What are you doing to protect yourself and your family?
Forewarned is forearmed.
Tuggle is a professor of information systems at Chapman University and a partner at Insight Consulting Partners LLC.
