Electronic meds make for big headaches

THE BIG PHONE COMPANY, Verizon is making a big deal about giving its employees an “Electronic Personal Health Records tool”. Participating Verizon employees can use the health records tool to store health care information on a password-protected Web site, which employees and their designated health care providers can access from anywhere in the world. It's supposed to save money, allow providers to access on-line records more quickly, empower the employee, blah-blah.

Based upon something I witnessed last week, I say “Lots of Luck.”

On Wednesday evening, a man in an outlying area of Washington D.C. had trouble breathing, lightheadedness, dizzyness, goes to his local hospital emergency room. Turns out he has some seriously big time heart problem. As a part of the diagnostic process, he gets a chest X-ray.

The decision is made to move him from the local hospital to MedStar and the Washington Hospital Center in the wee hours of Thursday morning. His chest X-ray film and a big box of paper records are bundled up and shoved into the ambulance along with the man.

After a miserable bumpy ride from the countryside to the big city (he didn't get the helicopter ride because it was too foggy), he is admitted to the MedStar emergency room. The ER team shoots a second chest X-ray shortly after he arrives, says this one will be in the "computer system" at Washington Hospital Center. His first X-ray, taken less than six hours, remains pristine in its neat brown folder.

At this point, I'm wondering why they can't simply scan in the first X-ray, since it would be cheaper and quicker. Maybe they don't trust the country bumpkins to take a chest X-ray properly. Maybe it's a lawyer liability issue.

Around 5 AM local time, the man is moved upstairs to the Coronary Care Unit (CCU) at Washington Hospital Center, monitored, poked, prodded more. During the diagnostic process, a technician comes in to take a THIRD chest X-Ray. Something about the second X-ray not being in the system. This attempt is turned back, but the CCU finally secures a third X-ray later in the day. The patient is in no position to refuse. And the first X-ray sits in his room, in its folder, because it's not on the computer.

Three chest X-rays aren't going to kill you - they aren't exactly recommended for recreational thrills, mind you - but think about the time and energy it took to duplicate the same test. And this is on top of other diagnostic tests designed to complement the rough-and-ready chest X-ray.

My point to this story is we're in the 21st Century and U.S. hospitals are, at best, islands of data. At worst, they can't even store and move data from one specialist or primary care physician to an ER in the same building. Verizon is taking an interesting step to get their employees on-line, but what good is it if some poor SOB is unconscious or incoherent in the emergency room and doesn't remember his user ID and password to the website?

“Mufmpfot!”

“Sir, is that upper case or lower case?”

Unfortunately, major corporations are going to have to start beating on insurance companies and hospitals to promote health care IT interoperability. For all the hoopla about telemedicine and electronic record keeping, progress is occurring at a snail's pace. Older physicians are too fond of their paperwork and charts for medical records and have only implemented electronic systems for faster insurance billing. µ