We need a national medical records data base

[Mandy Muffin]

I spent some time this afternoon filling out forms for my South Florida cardiologist so he can obtain my medical records from my Cincinnati, Ohio based physician group. I am a snow bird and spend part of my year in Florida and the other part in the Cincinnati area. I have been doing this for the 15 years since my retirement and coordinating health care for myself and my wife is a nightmare. We need two sets of primary care doctors and specialists in each location. And they don't talk to one another!

This is ridiculous as my HMO in Cincinnati has a interactive medical records system called “My Chart.” https://mychart.trihealth.com/mychart/cgha.asp All my test results, including history, are there for me to review but other physicians can't look at the data. Why not? Because the USA has not initiated a system of having a national data base on medicine. We have a data base on financial health for everybody in the country by not physical health.

Last summer I got quite sick, experiencing a staff infection called C Diff. That winter in Florida I experienced illness from some severe digestive track diseases. After about $30,000 worth of tests, they took my gall bladder out, then told me I had diverticulitis and significant ulceration. I recovered well, loss some weight and was doing fine until the problems came back with a vengece. I was referred to a Gastroenterologist in my HMO who promptly requested all my record from the Florida Gastroenterologist. But it was a month later that he told me the records had not been sent. I was asked to make a phone call.

It seems a clerk in the office was asked to FAX the records but when the FAX didn't go through she just didn't do the job, nor did she tell anyone the records had not been forwarded. I talked to the office supervisor and got an apology, and my Cincinnati physician called the Florida physician. The records were FAXed with a paper back up sent to me directly. This action probably saved another $30,000 in new tests as well as the possibility of much more severe illness. Is this any way to run a medical system?  Why should we let the inaction of a clerk cost thousands and possible result in severe illness or even death. Doctors need medical data upon which to make decisions.  Keeping this data from them in not productive. 

We need a national health data base right now! It can save the lives of people who get sick on a vacation, business trip, etc. It can greatly reduce medical costs through eliminating unnessary testing. It is essential to anyone who splits their residence from one part of America to another.  The technology is there; we just don't do it as a nation. 

Here is a reference blog on the subject:  http://www.kevinmd.com/blog/2010/01/national-healthcare-information...

[Mandy Muffin]

America spends double what the rest of the industrialized world spends on health care and has a huge deficit in quality.  http://www.reuters.com/article/2010/06/23/us-usa-healthcare-last-id...  This is just an example of the jumble of uncoordinated and in efficient care we take for granted in the USA.  Unfortunately, much of the inefficiency of the system (the biggest being tort reform which can drive the cost of medicine up as much as 30% according to some studies) was not addressed by Obamacare, which expands this inefficient system to million for no cost.  I sincerely believe in Universal Health Care, but it should be done right, not just by extending the mess of inefficiency and overly expensive medicine to more people. 

[MGDJ]

The added benefit is that research could be easier and cost less from having centralized health records.  Medical companies could use records(by authorization from individuals) to build research without going through the formal processes.  As we know, much of the cost of drugs and medical devices comes from the heavy R&D costs involved in their design.

[Mandy Muffin]

I understand the privacy issue, but safeguards can be put in to protect it.  You could even give patients an option of not participating.  It would be a god-send to snow birds who split their year in two different parts of the country, to be able to have both physicians looking at the same medical record.  And for anyone who travels, a emergency room visit could happen at any time.  A complete medical record available to the ER Docs could save your life.  IMHO, this is a quality of life issue.

In fact, I own two Toyota automobiles.  All of my cars' records of maintenance are on a national data base so when I go to the Toyota dealer in either Florida or Kentucky they know everything about my car.  If we can do it for cars, we can do it for people. 

[exedir]

Having been on this type of activity since the late sixties, it still isn't working and still be like nuclear fusion in that it has been coming for over fifty years and probably be yet another fifty years.  

As a few days ago the VA said that they were abandoning their efforts in a centralize medical record.  The VA has been a pioneer in the EMR and has had one few a number of years as have some of the major clinics such as Mayo and Marshfield.  But then again it has been their own internal efforts to be more efficient and effective in their operations as to any convenience for the patients.

I know there are issue of technology, but they pale in the light of the politics.  The politics has to do with exclusive business advantages, who finances the EMR and how and the real issue, security and confidentiality.  

The Brits have tried this a great expense and with a much better structure to do it in and yet, they too have failed in the centralized record objective.

The need remains, the efficiency and effectiveness clear but the ability and well, questionable.