Why is it I can get money instantly from my bank account anywhere in the world, but my doctor has to ask me to have medical records sent to him? Use of information technology in health care is pathetic

I can do some amazing things, I can have my bank send me an e-mail each time there is a transaction in any of my accounts.  In fact, that happens within seconds of the transaction.  I connect my iPhone, my iPad and my laptop so when I change my calendar on one, it changes on all three.  I can also connect with anyone in the world on my laptop and have a video chat for free.  I don’t even pay my bills anymore, each company I owe money to simply takes it from my checking account each month or in some cases charges it to my American Express card where I accumulate points (that, by the way paid for a trip to Maui for ten days including first class airfare). Boy I can do all these amazing things and more and so can you.

What I can’t do is be assured that each of my doctors knows what the other is doing.  Each doctor asks me which drugs I may be taking and if another doctor has done this or that.  I hope I remember which drugs I may be allergic to because nowhere is this recorded and accessible to any doctor I may visit. Only because I have a health plan using a pharmacy benefit manager is there any hope of catching possible drug interactions. In the absence of such a plan you are on your own for such a risk.  When you do receive a prescription, it is generally on a piece of paper and you hope the pharmacist can read the instructions.  None of my medical records or procedures are automatically sent to my primary care doctor or anywhere else for that matter. When I visit a hospital I am asked to sign a release to have my records in a data bank accessible to doctors…in that hospital system.  Ah, progress.

There have been attempts to improve this situation and several are underway.  There is a hand-held device that allows a doctor to prescribe a drug with all the needed information on hand including optional drugs, information about the patient’s drug plan and it transmits the script directly to the pharmacy.  It is not widely used; nobody wants to pay for it.   We are a long way from a coordinated system that helps assure more efficient, higher quality health care for all.  Higher quality includes less risk for the patient from duplicative and unnecessary tests and errors.

This is nothing new of course, and yet we are still at it.  Here is something of interest from Bill Clinton’s attempt to reform health care in 1993.

As ‘The Clinton Blueprint: The President’s Health Security Plan’ (Times Books, 1993) points out, once you are enrolled, you will be assigned a “unique individual identifier.” “The unique identifier may be the Social Security number or a newly created number assigned to the health care system.” All of your medical information will be collected and stored in a “unified health information system,” where it can be accessed via your health-security ID number. And “an electronic network of regional centers containing enrollment, financial, and utilization data is created. The network receives standardized enrollment, encounter, and related data from plans for aggregations in analysis and feedback to plans, alliances, states and the Federal Government.”

Opponents of such a system see evil in the government having access to individuals’ health records.  Okay that’s fair, but what is the alternative?

We are never going to solve the core issues for health care in America unless we throw off the chains of outdated thinking and old norms and perceptions.  As much as we like to think otherwise, health care is not an individual thing that only involves one patient and one doctor and no other interested parties.