Sunday, August 09, 2009

Medical Information Technology

I went with Janet on Friday morning to see yet another physician, this one an ENT specialist (otolaryngologist) to have her hearing evaluated and to discover whether there's anything in that region of her body contributing to vertigo, a generalized lack of balance, and stuffiness and congestion.

The doctor, female and an osteopathic physician, saw her about 25 minutes after the scheduled 11:00 o'clock appointment time. To be fair, we arrived early knowing that we'd be faced with filling out a bunch of new information forms, something that is repeated each time you make contact with a new medical advisor. We were probably scheduled early to give us to time to fill out the forms. The office wasn't very busy. We only saw two other possible patients in the time we were there.

If you walked in and looked around, there'd be very little to tell that you were in an ENT practice. Almost all of the advertising materials on display had to do with cosmetic things, Botox, facial treatments, and plastic surgery. There was one rack that held a 4-page fold-out brochure from the American Academy of Otolaryngology. I grabbed a copy and its lying here somewhere, strewn among the things I'm trying to sort through following our move to Elizabeth St.

The point is, it got me thinking again about that whole process of grabbing a clipboard from the receptionist and filling out the forms for insurance, medical history, complaints, prescriptions, and anything else the doc decides is pertinent, and of course the obligatory and all-important insurance information. Oh, I already said that? OK. Over 20 years ago I worked on a research project for Honeywell centered on an optical storage card that was touted as a solution to a variety of needs in medicine, banking, business and you-name-it. It was a time before the internet, 'flash' drives, and PDA's, and even before the ascendency of insurance companies as controllers of medicine.

I'm trying to understand what the barriers might be to a universal patient health information system might be. It isn't technology; today's technology can easily accommodate such a system. It might have to do with a lack of standards; Doctor A and Doctor B could have different things they need to know about a patient's medical history. I suspect that patient privacy could be a significant barrier for some patients. Does my otolaryngologist (say) need to know my gynecological condition? (Not that I'm likely to have one, being male and all.)

I get my medical care from the Veterans Administration, as I've mentioned here before. The VA has a sophisticated on-line Patient Information Record system. My VA doctor can quickly pull up my information and see the results of all of my routine visits, lab results over time, all special diagnostics such as X-ray, MRI, and X-scopies, and all my prescriptions. If I happen to be away from Key West and am close to another VA facility and need to see a doctor, I'm pretty sure that he or she could pull up that same record and consult it.

I'm pretty sure that there are some entrepreneurial companies working on such systems. The American Recovery and Reinvestment Act is providing billions of dollars to foster the development of health information technology. If the controllers of that $800 Bn fund can figure out how to get it out there without the scammers getting hold of it, we ought see some pretty significant advances made over the next 2-3 years. Like this. I hope they do it -- soon.

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