A call to action: It's time for EMR

A few months ago while waiting at my doctor's office, I noticed a group of young people shuffling an enormous amount of documents on the other side of the glass partition. After watching a little longer I noticed a certain order to their apparently chaotic activity. The team was fishing manila folders out of a large box in the middle of the floor and, after a quick reading, reaching out for a binder in which to store them.

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When I asked the receptionist, she confirmed my suspicion: Those students were temp workers helping file patients' medical records. "It was about time," the receptionist added. "Some documents have been in that box six months or longer." 

"So the results of my last blood test are in that mess?" I asked, to make sure I understood correctly.

"Your papers and mine too," was the answer. "Like everybody else's."

Memories of that conversation came to mind just days ago, when I heard on National Public Radio that many medical records may have been lost in the destruction that Hurricane Katrina caused.

I couldn't help thinking that had I lived in one of the areas affected by the hurricane, my records would probably be lost, too. In contrast, my computers' backup tapes, stored in a vault at my bank, would probably be safe.

I find it rather sad that I have a better disaster recovery plan for my computer records than for my medical history. Unfortunately, I have little control over the latter, because my files are scattered amongst all the doctors and hospitals that have ever treated me. 

Should people care about losing their medical records if they were able to escape Katrina alive? Well, it depends. Losing your medical records is not a big deal if you've always been well, but people with serious illnesses may have a very different perspective. I have good friends with medical histories as imposing as the Los Angeles yellow pages. Losing that history could be a serious threat to their life and well being, as it contains treatment information, prescriptions, and all the other information that's vital -- and critical -- in case emergency treatment is necessary.

I've advocated storing medical records safely in a national patient database in this column before, and I'm doing so again.

EMR (electronic medical records) would make it easier to preserve, access, and store medical histories. Furthermore, there is an appealing financial incentive to move toward EMR, because it would improve the efficiency of the whole health care services industry, for which we all, private citizens and corporations alike, foot the bill.

Don't just take my word for it. A recent study published by the Health Affairs Journal (pay subscription required to access the full report) comes to this conclusion: "… effective EMR implementation and networking could eventually save more than $81 billion annually by improving health care efficiency and safety …."

That's no typo: Savings could be $81 billion per year. That figure, in essence, is the cost of inefficiently managing patients' records. It's an impressive figure, and could even double when you take into account the indirect benefits of EMR, such as better prevention and management of chronic disease, the study suggests.

But however promising the conclusions of that study, it will be a long time before my doctor's office will start filing patients' records electronically. After all, a doctor's office is essentially just another SMB, and the cost of purchasing and managing more computer systems is certainly one of the obstacles to adopting EMR.

In addition, the lack of a clear road map across the confusing galaxy of medical standards and applications is another, perhaps more formidable, deterrent. Obviously, doctors are reluctant to deploy systems that could later become obsolete or require significant adjustments to interact with a centralized database, the specs of which are still largely a work in progress.

Hospitals seem to have a more proactive attitude toward EMR, which is not surprising if you consider that they are facing most of that aforementioned inefficiency cost. For example, I hear from IBM that the St. Joseph's Hospital in Syracuse, N.Y., recently implemented a new PACS (Picture Archiving and Communications Systems), which, as the name suggests, makes it possible to store X-rays and other patient data in a central database.

For those who enjoy reading about vendors' scuffles, there's a bit of a story here: the hospital replaced an initial deployment of EMC gear (ill-managed for the previous six months by a third-party service provider) with Big Blue storage, attaining better performance and improved scalability at significantly less cost, the story goes.

I have no reason to doubt those claims, but in my view, the real scoop is the hospital's determination to put storage and other technologies at their patients' service.

In many hospitals, the "records room" is a back-office resource, usually detached from the front line where patients receive their treatment. All too often, when I've accompanied friends to a hospital, nurses and doctors found it more convenient to ask me about my friends' allergies or past illness rather than checking their records.

With the PACS technology, however, "our staff can access patient records and digital X-rays nearly instantaneously, helping to vastly improve patient care,” says Chris Ryan, manager of information technology at St. Joseph's.

As the St. Joseph's PACS story proves, creating a system to manage medical records electronically is neither easy nor painless, but it's certainly possible. And it can save lives and money. Can you think of a better reason to deploy such a system? I can't.

Join me on The Storage Network blog to discuss this and other topics.