Dr. Kenneth Mandl believes health information technology must be flexible.
(WENDY MAEDA/GLOBE STAFF)
DR. KENNETH D. MANDL | G Force
On the records
Dr. Kenneth Mandl believes health information technology must be flexible.
(WENDY MAEDA/GLOBE STAFF)
April 6, 2009
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In this wireless world, healthcare still has one foot in the digital dark ages. But the $19 billion investment in health information technology included in the federal stimulus package may change that, says Dr. Kenneth D. Mandl of Children's Hospital Boston. Creation of electronic medical records holds the promise of reducing medical errors and cutting healthcare costs. But Mandl says that policymakers need to make sure the technology is designed on an open platform so that new programs and applications can be invented. Here is an edited version of a recent conversation with him.
CAROLYN Y. JOHNSON
Q. How do consumer devices compare with doctors' tools for storing and sharing information?
A. A doctor in practice might be managing 3,000 patients and the tools they have, on the whole, are a telephone and a paper chart. None of us in modern day professions - whether it be newspaper reporting, or whether it be research or business - would tolerate that level of functionality.
Q. What's the state of affairs today?
A. Even in Boston, where we are wired and patients are benefiting from the use of these technologies in the healthcare environment . . . systems don't yet perform well. One issue is communication between systems - the data rarely gets from one institution to another. If I'm a patient at Children's and I get to be over 18 and I go over to Mass. General, my record does not [electronically] follow me there.
Q. You talk a lot about health information technology getting at least as good as a bank ATM. Can you explain?
A. The ATM model works because it's fairly simple in what it's trying to achieve. You can't go to the ATM and take out a mortgage. One way to get started building a capability that improves health would be to pick a task that is clearly going to help us provide better healthcare, like making sure patients have up-to-date electronic medication lists that are accessible.
Q. What can electronic medical records learn from the iPhone?
A. There's a very important message to be learned from the iPhone. There may be 10 or 20 different "to-do list" applications I can download and use on my iPhone, and if I don't like one, I can switch to another. What we find in health information systems now is the focus has been on building products installed in doctors' offices . . . monolithic systems where new features are quite difficult to add.
Q. How would medical records be kept safe and private?
A. In a personally controlled health record, the patient owns their own copy of the data.
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