In a New York Times op-ed piece, Dr. Anne Armstrong-Coben expresses concern that the modernization of medical records may not be as obviously beneficial as it seems. For one thing, there's no unified system yet, and the likeliest candidate (Google Health) isn't subject to the now-outdated Health Insurance Portability and Accountability Act, the national privacy statute. Creating an easy-to-learn and effective system is a huge undertaking, from construction to installation to training, and not everybody is confident it can be done properly.
A buggy or confusing system could result in more mistakes, not less, as Dr. Armstrong-Coben points out. "I have seen how choosing the wrong box can lead to the wrong drug being prescribed," she writes. Older generations of doctors may have trouble adjusting to a totally digital system, and there are bound to be mistakes made by even the computer-savvy before digitization becomes ubiquitous.
On the other hand, Dr. Armstrong-Coben complains that full digitization may make the doctor-patient relationship less personal, a point not likely to hold much water with digitization proponents. The potential money and lives saved far outweigh the loss. She reminisces, "I loved how patients could participate in their own charts - illustrating their cognitive development as they went from showing me how they could draw a line at age 2 and a circle at 3 to proudly writing their names at 5." Unclear, however, is why she can't just keep a notebook in which her young pediatric patients can ! draw.
Obama's plan will cost about $100 billion, a huge chunk of the stimulus package, but some experts claim it will save two to three times that yearly. Those savings could go toward universal health care or simply flow back into the hospitals for better equipment.
Doctors like Armstrong-Coben bring up an interesting point: this is a new frontier and a massive project, and it won't be as simple as handing doctors a new iMac and watching the savings roll in. But it's a necessary step; just because it's going to be hard doesn't mean it's not worth the effort. [NY Times and CNN]