WHEN IT COMES to switching from paper to electronic records, medicine trails many other professions — even though study after study has shown that computerization will save not just money but lives. Even with the incentive of billions of federal dollars to cover much of the cost of the transition, doctors and hospitals have been slow to take even the first steps toward conversion. Apparently, they feel little or no responsibility for symptoms that get misdiagnosed because of inadequate information about a patient’s past medical care, let alone the tests that get repeated because no one has a record of the previous results.
In addition to offering the carrot of billions of dollars in stimulus-bill subsidies, the Obama administration is wielding the stick of reduced Medicare payments to doctors who do not make the change by 2015. Already, some medical professionals believe that date is too soon. But if anything, the deadline gives medical providers too much time to put off the inevitable. Under no circumstances should the administration backtrack on its threat.
The conversion to electronic medical records will be a headache, especially for small practices led by physicians who got their training before the digital revolution. The federal government should assist not just with subsidies but also with technical guidance to ensure that doctors and hospitals have software options that achieve a range of goals, including interconnectibility and the capacity to transmit prescriptions directly to pharmacies.
According to the Institute of Medicine, 50,000 to 100,000 patients nationwide die annually of preventable medical errors. Just computerizing doctors’ orders for drugs and tests could reduce that toll substantially. But a 2008 study by the Massachusetts Technology Collaborative and the New England Healthcare Institute found that just 10 of the state’s 73 hospitals had a computerized system for doctors’ orders. According to the study, 1 in every 10 patients at six community hospitals in the state suffered serious medication mistakes.
Hospitals have been even slower to adopt fully comprehensive electronic records. According to a national survey reported in the New England Journal of Medicine last year, just 1.5 percent of hospitals and 4 percent of doctors’ practices meet that standard. These figures are discouraging. Electronic records will prevent errors, improve diagnostic work, avoid duplication of tests and procedures, and simplify clinical studies. A potent elixir for many of the health care system’s ills, they deserve every push the federal government can give them.
But the ultimate responsibility belongs to the doctors and hospitals who are putting their own habits ahead of the clearly demonstrated needs of their patients — and of the taxpayers who foot the cost of many medical bills.