Electronic medical records


So Bush is wanting “medical record keeping to be updated to the 21st century.”:http://www.wral.com/health/3243106/detail.html Fine. Electronic medical records have great potential:
* Joe wants to get high by using Oxycontin. He goes to 5 different doctors complaining of intense pain. Electronic records could prevent this, as doctor number 2 sees that Joe already has a month supply.
* Say I get in a car wreck in California. Trauma doctors can easily see that I have a history of penecillin allergy, and choose another antibiotic instead, potentially avoiding a fatal reaction.

However, it’s the following scenario that concerns me.

bq. Fred gets laid off, and, before his health insurance expires, decides to go in for a physical. The doctor gives him a clean bill of health, but, instead of coding 43 for “Clean bill of health,” the assistant codes 443 for “metastatic lung cancer.” He goes to a few job interviews, and prospects look good. But he gets mysterious dismissal letters: “Thank you for your time. Our position has been filled.” Not even a “resume is on file,” etc.

bq. One year and fifty failed interviews later, Fred is depressed and broke. He sells his house and moves in with his brother. There, on a Friday afternoon, he stubs his toe so hard it breaks and has to go to the doctor. The doctor pulls up his record, gets a funny look on his face, looks at Fred, looks back at the computer, and asks Joe what he has been doing for his cancer. Fred emphatically states that he does not have cancer, but the doctor orders a biopsy. Fred’s sister-in-law comes in, holds his hand, and says that it’s ok to talk about his cancer. His brother says that they’ll help cover the cost of the biopsy, which, because Fred has been out of work and can’t afford health insurance, he’ll have to pay out of pocket. Two weeks later, again on a Friday afternoon, the biopsy results are negative and everybody breaths a sigh of relief. The doctor’s assistant issues a correction. Of course, Fred could have told you that two weeks before.

bq. With renewed vigor, Fred interviews for jobs again, but still gets rejected. Because the correction went in on a Friday afternoon and the government clerk left early that day, the medical record never got approved and changed. But Fred, not knowing that, starts thinking that he’s unemployable, goes to live on the streets, takes up smoking, and eventually dies of — you guessed it — metastatic lung cancer.

Somehow, I don’t think that electronic medical records are going to solve all the problems that Bush says they will.

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