An electronic prescription for the healthcare system

Doctors are getting digital help to do their jobs.

President Obama is betting big on information technology. The plan is to use electronic medical records to prevent costly errors, reduce paperwork and better track what works to keep people healthy. But less than 20 percent of U.S. doctors and hospitals use e-records now. So Congress has set aside $19 billion to encourage others to go digital.

Listen: [audio:090624tedigital.mp3]

Dr. Jean Stretton carries a laptop from one exam room to the next, and has instant access to her patients’ medical history and test results. All that information should be available in a paper chart. But paper gets lost in the shuffle. And sometimes doctors forget to review what is written down. Dr. Stretton says an electronic prescribing system double checks her work.

Stretton: I’m less likely to make mistakes, if I start to order amoxicillin and that person is allergic to penicillin it shows up right away as a red flag.

Stretton leads Gateway Medical Associates. Three years ago, the practice was drowning in paperwork. These days prescriptions go from Stretton’s laptop straight to the pharmacy. When a patient calls in, questions are entered directly into a digital file. There’s no need to go find a chart, or attach a sticky note.

Stretton says her patients do worry, though, about privacy, and the security of their medical data.

Stretton: If my laptop would be stolen, it has no information on it; all the information is stored on the server.

When someone peeks into a paper file, there’s no way to know. When an electronic file is opened, usually there’s a digital record of the breach.

Stretton likes to tell the Hurricane Katrina story to illustrate the other advantages.

Stretton: The doctors who had electronic systems that were backed up in other states, they still had their records. The ones that had paper records, people lost what treatments they had gotten for their cancer, their records were lost.

The practice has saved enough on paperwork to earn back its initial half-million dollar investment, and Stretton expects the system to keep paying off.

Stretton: One of the things we knew is that in the future doctors would be paid according to giving good care to their patients not just according to how many people walked in and out the door.

The Medicaid and Medicare programs will soon pay bonuses to providers who prove they’re “meaningful” users of electronic records, and the Obama administration is drafting a policy to figure out who will qualify.

Todd Park analyzes health policy at the Center for American Progress. He says estimates on the potential cost savings of electronic records range from “nearly nothing” to $80 billion a year.

Park: Health IT by itself, right, doesn’t cut cost. Health IT by itself doesn’t put hands on people and make them better. It’s what health IT is used to do that matters.

At an expo in Harrisburg, tech salesman Patrick Kenny demonstrates. He says doctors can sort through thousands of patient records quickly to figure out who’s had their flu shots and or who’s missed a mammogram, or even chart a year’s worth of cholesterol tests for a single patient.

Kenny: And I can graph that lab over time, so if there are multiple labs, I can see if that patient is doing better or doing worse, and once again all that’s available with the click of a button.

Experts warn that health IT can’t drive down the cost of care unless more providers digitize their data, link with one another – and then use that information to guide care decisions. Greencastle Consulting helps hospitals make the digital switch, but founder Jacob Kretzing says lots of providers are hesitating.

Kretzing: You may have one physician who’s kind of leery to provide that information about the patient because there’s the fear that I may lose that patient if another doctor has access to that information.

Some say it will take more than the federal program to push providers past their inertia, and many expect states to step in with their own incentives to nudge doctors and hospitals into the digital age.