Electronic Health Record in the USA

When Obama first got into office, he talked about saving money by implementing an electronic health record. Now, I don’t hear so much about that. So I did a little investigating to find out how well an electronic health record (EHR) would work.

Great Britain and other parts of Europe are in the process of implementing an EHR that crosses boundaries and interfaces with most computer systems. The current recession has called for scaling back the programs, but they are still moving forward. The Veteran’s Administration (VA) has been praised for its use of a very effective EHR for many years. But in Europe, they don’t have to deal with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the VA is nationalized medicine for veterans (basically, it's one gigantic doctors office). HIPAA has been great for ensuring patient’s privacy. But…

HIPAA can also be thought of as Mordac: The Preventor of Information Services.

One problem with HIPAA is that Provider A can’t share health information with Provider B without the express written permission of the patient. If you live in California and happen to get run over by a bus and knocked unconscious while on vacation in New Jersey, the doctor in the emergency department has NO CLUE what your medical history is, what medications you take, what you’re allergic to, or why you chose New Jersey as your vacation destination.

Well, ok. We can’t share our health record from one state to the next, but an EHR in the doctor’s office or in the hospital would be really handy, right? Maybe. My doctor utilizes EHR, but the next doctor I go to may not use the same software program. How do I get my information to my new doctor? Go back to paper copies.

For an electronic health record to be truly useful in the US, it needs to be fully portable and universally accessible. But, the current interpretation of HIPAA says we can’t have an EHR that follows us around the country for our whole life. HIPAA says our health record has to be fragmented in order for our privacy to be secured.

In the event of an emergency, I don’t want my doctor to have to guess at what’s going to hurt me and what will help. I would much rather run the risk that someone finds out I once had an embarrassing infection, than to have my doctor prescribe me a medicine I’m violently allergic to while I’m unconscious and can’t object. It seems like a no-brainer to me, but then an embarrassing infection won't keep me from getting re-elected.