Is It Finally Time to Put Patients' Medical Records Online?
October 05, 2005
Although it has been a long time coming, physicians are beginning to consider the Internet an integral part of their practice.
For example, instantaneous electronic transmission of a patient's records from his or her doctor to another part of the country (or the world, for that matter) could be extremely helpful in an emergency.
There's even a trial going on in Florida in which doctors are being reimbursed for online consultations. About 1,000 doctors and 100,000 patients are participating.
However, there are still a couple of issues that keep medical professionals from stampeding into cyberspace.
First, old habits die hard. Manual record-keeping is as much a part of many doctors' habits as a cold stethoscope and a lollipop for the kid with the sore throat. Many physicians are comfortable with their record-keeping and see no real reason to change.
Second, there's the larger issue of security on the Web, coupled with an already-suspicious public when it comes to releasing their medical records to anyone without their consent.
The federal government's attempts to ensure medical record privacy protection resulted in a 2002 law that didn't completely satisfy anyone. While the law gave patients the right to inspect their medical records and correct mistakes and see who else has looked at them (including the ability to penalize anyone who uses the information improperly or illegally), it stopped short of requiring the patient's written permission to release the information.
So, a natural suspicion exists among both patients and doctors about keeping medical records online. And not helping at all are the sporadic reports of computer hackers infiltrating the Web sites of everything from credit card companies to the Defense Department.
Those in the medical profession who advocate electronic and Internet medical records say they realize it's going to be a long selling cycle. Yet, this revolution in health information technology, the advocates say, will save money through less paperwork, result in greater productivity, and substantially reduce the number of costly and tragic medical errors, which claim the lives of an estimated 195,000 patients annually.
The American Medical Association and 13 other medical groups representing 500,000 physicians have already signaled their intention to go electronic. Last summer, the AMA helped create the Physicians' Electronic Health Record Coalition to recommend affordable, standards-based technology to their constituents. The group also will assist physicians who are primarily in medium-sized ambulatory care practices.
Meanwhile, the rush is on in the private sector to find the "perfect" software program that protects patient privacy while utilizing the latest Internet technology.
One such company is REDmedic Inc., a California firm that emphasizes the interactivity between the technology used by patients and the doctor's online and electronic record-keeping abilities.
The company says subscribers who sign up for the self-service Web site will be able to collect, store and access everything they ever wanted health-care professionals to know about their medications, allergies, immunizations, conditions, doctors, emergency contacts and insurance providers.
The annual membership is about $35, and REDmedic says the price will be going up next year because it's introducing new technology.
"We will then be able to store and transmit more complex information such as advance directives, EKGs and other essential medical documents and diagnostic imaging techniques," said Ken Toren, REDmedic's vice president of marketing. The privately held company claims to be the first online personal health information service capable of delivering information to any doctor or hospital, anytime, within the United States.
Dr. Edward Fotsch, who runs Medem.com., an online business that links the needs of doctors and patients through the Web, sees REDmedic as another version of an online personal health record.
"WebMD.com was the first one, and those interested can still find a personal site there," said Fotsch, whose business builds Web sites for doctors across the nation. Although he is enthusiastic about every inroad made by electronic medical records, he doesn't think that REDmedic stands any better chance for success than other companies that have tried to make a breakthrough in electronic medical record-keeping.
"We've learned through the years that people really want something that is linked to their own doctors and not floating in cyberspace," said Fotsch. "And, nobody seems to have an interest in paying for it."
But the big, traditional medical umbrella organizations are going to keep pushing the electronic agenda forward. Dr. Joseph Heyman, a member of the AMA Board of Trustees, was made point man by the organization because of his expertise in electronic medical records.
"I was chosen," he said with a chuckle, "because I have a totally paperless office I don't buy into this business that older doctors are too old to change. I'm 62, and I think the REDmedic system sounds like a good idea."
Lest the hospital point of view be overlooked, there is one administrator who is already working through the huge upheaval that he anticipates electronic record-keeping will bring. Glenn Rispaud, director of Health Information Management at The Hospital for Special Surgery in New York City, is midway through phasing in a multi-million dollar system that is still in the contract negotiation stage.
"The new electronic system will make my job different, not easier," he said. "It is absolutely going to change the way we do business."
SOURCES: Ken Toren, vice president, marketing, REDmedic Inc., Santa Clara, Calif.; Edward Fotsch, M.D., CEO, Medem.com, San Francisco; Glenn Rispaud, director, Health Information Management, The Hospital for Special Surgery, New York City; Joseph Heyman, M.D., member, American Medical Association board of trustees