Care For PA

Advances in medicine spurred by technology have changed what once were considered "terminal diseases�? to that of "chronic conditions�? and have made some procedures, such as organ transplants, more routine and safe. Yet despite these medical miracles and increases in life expectancy, the tools used to manage and track health care have not advanced at the same pace. Not much about the traditional paper medical file has changed over the years, until now.

With a series of reports and articles noting the shortcomings of using a paper patient record keeping system, along with a push from President Bush, who in 2004 called for a national health information technology effort, major strides are being made across Pennsylvania and the nation to use electronic health records and the secure exchange of medical information to help transform health care in America.

What's the Problem with Paper?

Problems with a paper-based system are many and affect health care providers as well as patients. Some are a matter of inconvenience--like waiting for vaccination records before a parent can take a child to camp or enroll the child in school. Others are more critical--like treating a patient who is in a life-threatening situation far from home, but is unable to supply that health care provider with detailed medical information from their home community provider.

The paper-based system of medical information makes medical records and tests difficult to share with patients and other medical providers because they're stored in different doctors' offices, hospitals, and labs. It also can result in difficulties in making diagnoses, duplicate testing, conflicts in prescriptions, wasted time for doctors and patients, decreased quality of care, needless expense, and unnecessary worry.

What's the Solution?

The solution is to connect health care information electronically. The concept is fairly simple: information relevant to a person's health care should be available wherever and whenever it is needed and authorized. The ability to connect people's information, to move it where they want it, to put it in the hands of their trusted physicians and caregivers, and to guard it from prying eyes and accidental disclosures is here and the benefits are many (see sidebar).

There's no doubt that a truly connected system of health care information will be a major shift and will take time and money. Hospitals currently bear almost all of the costs of information technology investment, with little financial support from government or insurers. In Pennsylvania, the median amount of capital spending on health information technology systems in 2005 was $1.5 million, representing 15 percent of capital budget. That number is expected to jump to $4.5 million per hospital, representing 20 percent of capital budget, over the next three years. This type of investment is similar to that experienced in banking and other businesses moving into the electronic age.

In Pennsylvania, a coalition of more than 225 individuals representing 160 different health care-related organizations are working together under the auspices of the Pennsylvania eHealth Initiative to foster use of electronic medical records across the state and enable the secure, timely, and efficient sharing of patient information. Efforts like this are working and the truly connected system is coming about through changes in communities across Pennsylvania and the nation.

For example, Geisinger Health System, Danville, has a system that allows patients to request prescription refills, view and graph lab results, access their medical history, review their medication and allergy information, pay their account balances, request appointments and referrals, schedule their own appointments with their primary care physicians and communicate directly with their doctor's office using a secure online connection.

In the face of a sometimes complex or intimidating health care delivery system that is already using amazing technological advances to save lives and improve lives, it might seem that what is affecting health care is too much technology, not too little. But the reality is different. A connected health care system--where consumers' privacy is protected and their convenience facilitated, where doctors and nurses have the information they need to efficiently deliver safe and effective care, where our public health and homeland security can be protected while still guarding each individual's privacy--will help us to improve health care quality, prevent medical errors, reduce health care costs, improve administrative efficiencies, reduce paperwork, and increase access to affordable health care.

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