BY SHERI PORTER
Twenty years ago, 300 people -- likely all labeled "computer nerds" by their co-workers -- attended a conference to discuss electronic health records. On May 17 - 21 this year, that same conference, TEPR, or Towards an Electronic Patient Record, drew about 4,000 people from 25 countries to Fort Lauderdale, Fla.
Electronic health records have become a big deal in 2004; this year's TEPR spotlighted areas where information technology implementation will make a footprint physicians and patients can't miss.
Boosting patient safety
 After a press conference at the TEPR convention in Fort Lauderdale, Fla., David Brailer, M.D., PhD., right, HHS' coordinator of national health information tehcnology, shares a light moment with David C. Kibbe, M.D., director of AAFP's Center for Health Information Technology. |
Lawrence Weed, M.D., has worked in the field of health informatics for decades. Delivering TEPR's opening address, he argued that the health care industry sorely needs a method of efficiently tracking errors to improve patient safety.
Look at the airline industry, said Weed. The pilot relies heavily on computerized equipment, and when something goes wrong, the data enables experts to trace the source of the problem. The system is set up to provide feedback, and that's what EHRs can do for health care. "A system without feedback goes wild, and medicine is going wild," said Weed.
Add to that the impossible amount of information physicians are expected to keep in their heads, said Weed. "What do you do when the task is quantitatively bigger than the human mind can handle? You get a new tool to master all the details, a knowledge compiling tool." Namely, you get an EHR.
All these years, "we've kept records on what was done, but not on why it was done," said Weed. No one knows what a physician is thinking while writing an order, and "every doctor plays with his own personal deck of cards and a different deck every day depending on how busy he is," Weed added.
Physicians have shortchanged data collection for years, said Weed. The time is perfect, in light of patient safety issues, for implementation of standardized EHRs.
Enhancing patient communication
E-mail. Web messaging. Practice Web sites. All are opportunities for physicians to communicate with their patients. And according to Daniel Sands, M.D., clinical director of electronic patient records and communication at Beth Israel Deaconess Medical Center in Boston, that's exactly what physicians should be doing. Why? Because every day, more people go online for health information than see a physician, according to Sands.
If that doesn't shock you, this might: More than half of those people will act on information retrieved online. Yes, patients are deciding whether to stop or start medications based on what they're reading on the Internet, said Sands.
Wouldn't a better alternative be for patients to access good health information at a trusted physician's Web site?
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Nearly a third of patients say they would switch physicians if they could find one who uses online communication, said Eric Liederman, M.D. |
According to Sands, patients want access to physicians' Web sites for patient education, test results, prescription refills, appointment scheduling and to discuss symptoms and treatments.
It's the physicians who are dragging their feet, said Eric Liederman, M.D., medical director of clinical information systems at the University of California, Davis, Health System. Physicians cite these fear factors:
If you're not convinced that patients want direct communication with you, chew on this statistic: Nearly a third of patients say they would switch physicians if they could find one who uses online communication, said Liederman.
Do you want to lose your best patients? "We don't want our baby boomer, computer-literate patients who care about their health going elsewhere," he said.
To reach writer Sheri Porter, e-mail sporter@aafp.org.
FP Report is published by the
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Copyright © 2004 by
American Academy of Family Physicians.