Dispel privacy concerns and use technology to bolster care, cut treatment costs

Imagine never having to fill out paper forms on a wooden clipboard every time you enter a new doctor's office. Imagine that your entire medical history and profile belonged to you from cradle to grave, accessible to you and any medical practitioner that you authorized.

Imagine never delivering a handwritten prescription to a pharmacist or duplicating a procedure because the previous results were unknown or inaccessible. Electronic medical records can make this possible.

Electronic medical records are a major component of how information technology could transform our health-care system, offering tremendous opportunities to reduce health-care costs, improve quality of care and save lives.

Instituting a standardized, nationwide electronic-medical-records network will require coordination among multiple stakeholders. This includes patients who fear their privacy being breached, doctors who are concerned that electronic health records could alter their work practices, and hospitals and clinics that wonder how they will pay for such an undertaking.

Another challenge is that U.S. health-care services are diffused among hospitals, clinics and sole practitioners. This diversity of choice undoubtedly benefits consumers. But an electronic-medical-records system only works effectively if the vast majority of health-care providers use it. Incentives must bring all providers and patients into a secure and interoperable network and encourage everyone to participate.

However, these concerns are small when compared with the benefits. The most obvious is that a nationwide electronic-medical-records network would reduce the rising costs of health care. The RAND Corp., a think tank based in California, concluded that a nationwide electronic-medical-records system could save up to $346 billion annually.

If 90 percent of doctors and hospitals used electronic medical records, the reduction in duplicate procedures would save $77 billion annually, alone. On top of that, $4 billion could be saved by reducing prescription errors. An additional $81 billion could be saved through more efficient, early treatment of chronic disease, resulting in healthier patients and fewer hospitalizations.

The remaining cost savings would result from an even more transformative use of electronic medical records: using the data gathered to analyze and improve treatment methods.

Paper kills. The Institute of Medicine estimates that between 44,000 and 98,000 Americans die from medical errors annually. Electronic prescriptions are far less likely to be misread than those handwritten on paper. Harmful drug interactions are far less likely to occur when automatic notices alert doctors of potential dangers.

Electronic medical records help clinical staff concentrate more on patient care and less on record-keeping. In an emergency, your doctor would have complete access to your records and would be able to quickly and more efficiently provide treatment without having to run duplicate tests.

Furthermore, electronic medical records would help doctors focus on preventative care, which is critical for chronic diseases. Seventy-five percent of all health-care expenditures pay for treating chronic diseases.

Electronic medical records are also vitally important in national emergencies. During Hurricane Katrina, thousands of paper medical records were destroyed. However, the records kept by the Veterans Administration are stored electronically and, as a result, were not lost in Katrina. They were instantly accessible by medical staff from network servers far from the destruction.

Digitizing medical records nationwide offers enormous benefits but also carries a legitimate concern: maintaining individual privacy by securing the records from unauthorized or malicious use. Privacy protections must be the cornerstone of an electronic network. If patients, doctors and hospitals feel the network is not secure, they will not opt into the system.

Securing the system requires both legal and technical safeguards. Legal means already exist through the federal government's Health Insurance Portability and Accountability Act requirements. Technical safeguards could include encrypting patient information and diffusing the information across multiple databases; leaving ownership of the record to patients, who would need to provide pin numbers or passcards; or providing other security methods to allow medical practitioners to have access to records.

The federal government, which pays more than 40 percent of all U.S. health-care expenses, has the leverage to shape an electronic medical records system.