Both Mr. Ellis and I have written recent posts (…here, here and here) about a subject that most Americans are, at best, only vaguely aware, but which will change the way medical care will be delivered for many years to come. I am referring to electronic medical records (EMR), also called computerized medical records in the UK.
The hasty passage of the so-called “stimulus package” in the House now sends the bill to President Obama’s desk for signing next week. Of the 1100 pages of the bill, over 400 refer directly to health care delivery, including the formation of a huge new bureaucracy, a National Coordinator of Health Information Technology.
This will be a board of government employees, appointed by the President that will be tasked with assessing the cost effectiveness of medical treatments, drugs and diagnostic tests. The board will decide what medical decisions are appropriate and those that are not, with payment to doctors and hospitals tied to those determinations. But that’s just for starters. When fully implemented, this same board will make decisions about hospital accreditation, physician licensure and board certifications. Simply stated, we do it their way or find another job.
Presently only about 17% of physician practices are fully computerized, but new legislation will require compliance by all hospitals, clinics and physicians by 2012. The not-for-profit health care service that I work for went fully digital just a few months ago and we are still reeling with the consequences—long waits to see the doctor, intrusive questionnaires for patients with even minor problems, a 40% decrease in the number of patients we are able to see in a day and regular “crashes” of the system that require that we go back to the paper system only to spend hundreds of man-hours entering the information into the EMR when the system comes back on-line.
Currently, the digital records in our offices are only for use within our system and do have some advantages in terms of availability of records and test results that help in physicians’ decision-making, but the federal bureaucrats have bigger plans. All electronic medical records will eventually be fed into a national database that will be used by countless agencies to make demands about you and your doctor’s decisions.
For years, Democrats and liberals have insisted that the relationship between a woman and her doctor is sacrosanct when it comes to abortions, but now we are told that that relationship cannot be trusted when it comes to Americans’ health in general. Obama, Pelosi and Reid now tell us that only with the intrusion of government can health care be high-quality and cost efficient.
How can we know whether government can do it better than you and your doctor? Well, we can see how well they’ve done with Social Security and innumerable welfare programs. And what about education? Or environmental regulations? Immigration? In fact, with the exception of the military, can you name a single federal program that is run effectively and efficiently?
The British, who have had decades of experience with their National Health Service, have had to begin rationing of basic medical care that Americans now take for granted. The Guardian of London had a story on Friday about the UK’s experience with their nationalized IT system that will link 50 million patients into a central databank similar to what is being proposed in the “stimulus bill.” With an initial cost of £12 billion the Brits are discovering that the actual costs are likely to be far more.
Andrew Way, chief executive of Hampstead’s Royal Free hospital, in north-west London, said his staff were “incredibly disappointed” with the IT upgrade on trial at the hospital since last summer.
“[T]he introduction of the CRS system at our hospital has caused much heartache and hard work and I would wish to pay tribute to our staff for all the difficulties they have faced during this time. It has been extremely difficult for them and has created a substantial additional workload.
Way told the BBC: “I have personally apologised for the decision to implement the system before we were really clear about what we were going to receive. I had been led to believe it would all work.”
He said the hospital had spent an extra £4m to get the system working, with added administration costs including 40 extra staff to handle the additional workload.
He said a further £6m was effectively lost because of fewer patients, and problems with the system meant the hospital was unable to bill other parts of the NHS for work done.
He also said the Royal Free had been unable to invest in new equipment, and outpatient bookings were taking four times as long.
Last month the Commons public accounts committee (PAC) warned of further delays to the scheme and described progress as “very disappointing”.
Security fears have also been raised over the confidentiality of patient medical records. (The Guardian)Americans will soon discover the true costs of “free” health care in terms of availability, government intrusions and loss of privacy.
The Soviet Union used to brag about their medical system that had a “doctor” in every village and neighborhood. The doctors were poorly trained, had virtually no modern diagnostic tests and even less in medicines and therapies—but, it was free!
A wise and worldly professor in medical school once told me that the most expensive medical care is that which is useless.