Electronic health records are wrong prescription for automation

The failure of these systems to catch on is not uniquely American.

The British government initiated a 10-year, multibillion-dollar project to implement a national patient record system in 2002.

The British House of Commons published a report in September 2007 and described in painful detail the data collection challenges, budget and schedule overruns.

The irony is despite the single-payer system in Britain, which should make electronic patient records easier to achieve, the British government is learning the hard way that it might be mission impossible.

In comparison, Americans receive health care through 500,000 office-based physicians, 5,000 community hospitals, 16,000 nursing facilities and hundreds of insurance companies, with a full spectrum of ownership, pricing systems and data formats, including paper-based information.

The health care market fragmentation in America creates a formidable challenge compared to the British system.

The electronic health record concept is easy to describe, but the difficulty in achieving such a system is enormous because it is fundamentally not a technical problem.

Under the current rules and regulations, medical records belong to the patient.

But each individual patient’s information resides in dozens of different places, such as the family practitioner’s office, the lab, the hospital, the drugstore and so on.

To create a system of electronic patient records, an individual must have the will to track down — and collect — the scattered data from both different sources and in vastly different formats.

The individual then has to have the access, the know-how and time to enter all this data — error-free — in a single system. The bigger challenge is to keep the data up-to-date as new procedures, medications, referrals, etc. are added.

Electronic health records are the wrong prescription for health care automation.

The right medicine is developing the ability to connect different systems seamlessly through a network of interfaces, or an interchange, that will enable the temporary collection of patients’ data at the right time and place.

The interchange solution is established and proven.

In the travel industry for example, a trip can involve data from multiple carriers, hotel chains, car companies and tour operators.

The trip can be sold online, or through millions of travel agencies all over the globe. Passenger records, such as frequent flyer miles, seating, meals, hotel and car-size preferences are maintained, used and updated for years.

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