Most observers agree that putting medical records online is inevitable
Prognosis for e-medicine Doctors, patients go online for efficiency despite healthy concern for privacy
BY PAULA FELPS
Dallas Morning News
Steve Yates is one of a growing number of physicians who has veered away from the paper trail.
Yates, who practices internal medicine, is completely wired at his office at the North Texas Medical Group in The Colony, Texas -- something he says has improved the clinic's communication and efficiency.
``Basically, there's no paper because everything is done electronically,'' he says. ``My patients can contact me by e-mail so they don't have to play phone tag. They can schedule appointments, ask questions, get prescription refills -- and not have to worry about waiting for us to call them back.''
If the growing numbers of software programs and online resources are any indication, more medical professionals appear to be turning to electronic options in their offices.
Yates is among those who believe automated medical records systems cut down on paperwork and allow for greater communication between doctor and patient, as well as doctor and staff.
The electronic path ultimately leads to placing patient medical records online, something being tried in many hospitals and offices. Online medical records give doctors immediate access to the medical history of new patients, as well as provide physicians with longtime patients' charts with a few keystrokes.
While most agree that putting medical records online is inevitable, many are uncomfortable with the notion.
Jane Chihal, a Texas obstetrician/gynecologist specializing in infertility and co-author of the book ``1,000 Health Questions for Women,'' says she has yet to dip her toe into the electronic wading pool because of security concerns.
``We keep patient records on our (office) computer, but frankly, I don't even trust the Internet with my credit cards,'' she says. ``I know they say it's completely secure, but how secure is it really?''
She points to certain private data, such as infertility issues and screenings for sexually transmitted diseases, as information that patients wouldn't want to risk sharing with strangers.
But Chihal says technology is coming that will allow records to be stored securely in electronic form.
At the moment, she is careful to keep even her e-mail correspondence with patients at a safe level.
``If it's too personal, I don't send (the information) by e-mail. I'm sure in the future that will change.''
Forrester Research, a Cambridge, Mass., firm that conducts Internet surveys, projects that Internet services will account for 16 percent of total health-care expenditures by 2004, with physicians and other health-care providers processing $224 billion in insurance claims online. By comparison, last year the industry spent just $6.4 billion on Internet health-care services.
Paul Ratcliffe, director of information systems for RHD Memorial Medical Center in Carrollton and Trinity Medical Center in Farmers Branch, Texas, says that electronic medical records are becoming standard.
``We're still at a fact-finding level and have not yet put everything online, but we do have a lot of things in place for the doctors,'' Ratcliffe says.
As with the traditional paper method, electronic records aren't completely immune to falling into the wrong hands because ``nothing is 100 percent secure.'' But encryption certificates and high security make the likelihood of that happening slim, he says.
``It's as airtight as getting information over the telephone,'' he says.
The difference, of course, is that the electronic version can move from one doctor's office to another more quickly, saving time both for patients and physicians.
``If it's online and a patient comes in with a problem, the doctor can go online to immediately check their history instead of doing a lot of legwork. It speeds up the diagnosis.''
Yates says it also allows doctors to provide patients with information that wasn't accessible in years past, such as checking on drug interactions.
``If a patient is on 15 medications, you can check and see if there are any possible interactions between the different medications. That's something you just could not have done manually,'' he says.
He says the advantages of online records extend to emergency-care physicians, who might treat a patient in the emergency room and could have instant access to vital medical records.
``The approach to technology has always been, `How can I take this and make more money with it?' '' Yates says. ``But the fact is the main reason to do this is for improved patient care.''
However, many are concerned that doctors are trading patient privacy for that improved care.
``We don't recommend that physicians place medical records online,'' says David Winn, who left his medical practice to launch the software company e-MDs, which develops management software for physicians. Winn initially developed the software for his own use after being disappointed with what was available to doctors. He says security has been a major issue in developing the software, and his program is not designed to go online.
``A lot of physicians are refusing to go on the Web because the security, while it's fairly good, is not perfect,'' Winn said. ``The problem is a lot of physicians are just taking the vendors' word that the security is there. The myth is that the information you give to the insurance company is private.'' According to the Health Privacy Project at Georgetown University, 35 states, including California, have laws protecting private medical records.
The Health Privacy Project also reports that one in five Americans already are victims of improper disclosure.
The idea of putting private medical and mental health records online has so alarmed mental health-care advocates that it is being addressed by such organizations as the American Psychological Association and the National Association of Social Workers. The social workers group has drafted recommendations to be included in federal guidelines.
Although guidelines are being developed at the federal level, physicians such as Winn and Chihal aren't likely to change their stance on online medical records anytime soon.
``I think in the future, we'll probably be able to use microchips and things like that to wear your medical records in your watch,'' Chihal says.
``But I don't know if the technology is available right now to offer the security that I would need to feel comfortable. For me, I'm just not ready to take that chance.''
www0.mercurycenter.com |
