The Downside of Electronic Medical Records
Part of President Barack Obamaâ''s plan to improve the U.S. health care system is to move every doctorâ''s office and hospital to electronic medical records. Most of the time, I think that will be a very good thing. This week, not so much. Because not even a state-of-the-art specialized highly secure record keeping system works all the time.
I live in Silicon Valley, and get my health care through a very large and modern group medical practice. It seems like weâ''ve had electronic medical records forever, though, thinking back, I have vague memories of the computers coming in, the conversion, and a period of extra-long office visits as the doctors struggled to input their orders correctly. Thereâ''s lots to like about electronic medical records; prescriptions are sent directly to pharmacies, so instead of dropping off a written prescription and coming back later to pick it up I only have to make one trip. I can make appointments online. I can look up test results and check when Iâ''m due for my next mammogram online. And, at least for my youngest child, I can print out a vaccination record myself whenever I need it instead of calling the office and asking for a printout (and sometimes being charged for the service).
Not that there arenâ''t some things about the electronic medical system that bug me. That prescription transmittal? There appears to be no way of telling the system not to send a prescription to the pharmacy whenever the doctor updates it, so when I have an annual checkup I can either choose not to update my allergy prescriptions (which means a phone call to the doctor a few months later when I need the medication), or go for the update and end up buying a new supply of allergy medication, whether I need it or not. And Iâ''m currently shut out of two of my three childrenâ''s medical records; once a kid turns 13, their parent is not allowed to access an electronic medical record. However, the kid himself isnâ''t allowed in until heâ''s 18. A catch-22 that means Iâ''m back to making appointments, asking for vaccination records, and checking test results over the phone or in person.
But, in general, Iâ''ve been happy with electronic medical records. This week, however, the system went down. (A computer virus, a staff member told me.) And it wasnâ''t pretty.
On Tuesday, I went in with one sick kid, and was in for a long wait. When we finally got in to see the doctor, the reason for the wait was clear; the doctors had no charts, so had to at least review a basic medical history with the patients. Ordering a test took foreverâ''first, finding or creating a form, then, finding someone who remembered the code for the test, since there was no place to look it up.
The next day, I took a second sick kid to the lab for a blood test. The doctor had written out a paper order for the test, and I checked it carefully to make sure it was right and legible before handing it over to the folks at the lab. The lab technician read the paperwork and, by hand, copied the information, or so I thought, on labels for the tubes of blood (these labels are normally printed out automatically).
The next day, the electronic medical system was up and running again, so the good news was that the doctor could view the test results. The bad news was that it turned out the lab had run the wrong test and my daughter was in for a second round of blood drawing. She wasnâ''t pleased.
So yes, letâ''s move to electronic medical records, because, for the most part, they do make the process more efficient. But letâ''s not think that we can rely on them completely, throw out the paper, and forget how to do it the old-fashioned way.
Photo by J.Reed