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Off the Charts

Jun 28, 2008
About 20 years ago, we spent a long Martin Luther King holiday weekend in a Manhattan hospital, while a parade of specialists visited our bedside and tried to figure out why we had inverted T cells, chills, muscle strain, and chronic fatigue. A cardiologist finally figured it out, although we’re not sure why, since the solution was outside his purview. A recent bad cold had wiped out our thyroid gland. We’ve been taking synthroid ever since.

Once the solution was found, the symptoms made sense to everyone. At this point in time, we already had a few years’ experience with microcomputers, and we wondered why someone had not just typed our symptoms into a program when we were first admitted. Our affliction would have popped right up, possibly in a short list of suspects, saving thousands of dollars and no little anxiety on the part of our wife-to-be and ourself. We was told that no such program existed and that if it did doctors probably wouldn’t use it for fear of losing their god-given monopoly on making diagnoses.

Fast forward to 2008, and a special article published on June 18 in the New England Journal of Medicine, “Electronic Health Records in Ambulatory Care—A National Survey of Physicians.” This is the first large-scale survey of the use of automated record systems in physicians’ offices. Among the article’s findings:

  • Only four percent of physicians have “an extensive, fully functional electronic-records system.”
  • Thirteen percent more have a “basic” system.
  • “Physicians who use electronic health records believe such systems improve the quality of care.”
Well, duh!

The study further found that the most commonly cited barrier to adoption of these systems was their cost. Perhaps. But we wouldn’t be surprised if there were another powerful reason at work here, perhaps hidden even to the physicians themselves, and related to the one noted above. A greater-than-healthy ego is often part of the baggage carried by physicians. The same unwillingness to enlist the support of diagnostic databases that we witnessed 20 years ago may also explain the sluggish adoption of records-related automation in the office.

That a technology so powerful, so useful, so inarguably essential to the efficient management of a vital sector of our society should be so little adopted at the end of the first decade of the 21st century is a national scandal—in keeping with the general scandal that is health care in this country.

Next time you visit your doctor for a checkup, check up on them, and find out if they are among the four percent enjoying the manifest advantages of a full-functioning electronic records system in their office. If they aren’t, you might want to take yourself, and the rest of your life, elsewhere.

Meanwhile, we googled fatigue chills muscle strain and inverted T cells and zeroed in on hypothyroidism in .30 seconds.

À votre santé!
tags: Health

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