Why there needs to be a national healthcare information database
January 24, 2010
by Edward Pullen, MD
The majority of Americans have a great deal of personal health information in their physician’s medical record. Many of these physicians have an electronic healthcare record (EHR) to store this information.
Unless you are in an integrated healthcare system, and most Americans are not, this information is just not available to you or any physician seeing you who does not belong to the same physician group as your primary physician. Even your primary physician often will not have the latest information from your specialist physician or hospital. God forbid that you travel and need healthcare far from home.
It was proposed by Eric Schmidt CEO of Google last summer that we need a national data base to collect, store, and make available our health records to any physician we choose to let see them. To me, this seems just too obvious. Tremendous amounts of duplicate testing, and testing and testing done only because lack of availability of other information, is ordered by physicians doing their best to provide timely and quality care.
I do not know if this should be a government owned and operated data base, or a single privately managed and publicly funded data base. This is really not the issue. The real question is why is there not an overwhelming cry for a system like this. First is fear of “big brother” and misuse of the information. Will the information confidential enough? Could the system be hacked by cybercriminals or just vandals?
We just need to get over this concern. The benefits are just too big, and these concerns overblown. We just cannot afford not to have a system like this is place, both financially and to improve care. Would it be helpful to your ER doctor when you show up unconscious in a far away ER after a car wreck to easily access your medication list, allergy list, and list of diagnoses? Would it be helpful for her to know your last blood count to see if your borderline low count now is new, or preexisting? Of course it would.
A second concern is of course the cost of operating such a system. A critical evaluation of the cost and savings of such a system is needed, but I am confident it would much more than pay for itself. It would be one interface for all EHRs to work with. It would allow physicians to provide quality care, with current information about your prior tests and selected exam results, without having to order repeat or additional testing.
Another benefit to this type of system is that the NIH or other appropriate system would have access to a gigantic database to look at the health of Americans, allowing them to more appropriately target key areas for more research, intervention, and care.
Key elements needed in this system include:
· One system for all. Having multiple competing systems will fragment the information, and lose many of the needed benefits.
· Be federally funded, so that every American will be able to have their medical information included and appropriately available everywhere.
Edward Pullen is a family physician who blogs at DrPullen.com A medical blog for the informed patient.