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Electronic Health Records

As Congress argues over President Obama’s health care proposal, one major piece of his plan is already rolling out. The stimulus package passed in February included 20 billion dollars to get doctors to move to electronic health records, which Obama says will save millions. But two local medical professionals say electronic health records are about more than just saving paper. From the KUHF NewsLab, Melissa Galvez reports.



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So your iPhone can find the nearest restaurant, display reviews, and let you make a reservation for 8 PM.  But what if a computer could keep track of your allergies and even diagnosis your stomach problems?

“Now I can not only know that Mrs. Smith is in room 5 with chest pain, I can click on her, get her vital signs, if she’s had labs done, I can get those results, if she’s had an X-ray, I can see the results, so all of that stuff is much much easier with an electronic health record.”

That’s Dr. Brent King, an emergency physician at Memorial Hermann and LBJ Hospital.  Those two hospitals are part of only 20% of physicians who use some kind of electronic record.  But a computer does more than save paper.  By keeping and analyzing all of a patient’s information, it can actually help doctors make decisions.

“So let’s say that I’ve written an order for penicillin and it turns out that Mr. Jones is allergic to penicillin. The computer will stop me at that point and say hey doc, do you know that you just wrote an order to which the patient is allergic?” 

King says that electronic records could warn about drug interactions, remind about preventative tests, and an even suggest diagnoses.  They can also make it easier for doctors to communicate.  But Dean Sittig, an associate professor at the University of Texas School of Health Information Science, says that electronic records also come with complications.

“The physician has to figure out how to sit at his desk and type on the computer while still making eye contact with the patient, because otherwise the patient thinks that they care more about the computer than they care about them.”

Sittig and a colleague at Baylor College of Medicine have just published an article in the Journal of the American Medical Association outlining best practices. Doctors have to get the right hardware and software, make sure it’s compatible with other doctors, and train their people. But the most important part kink to be worked out is exactly how the computer interprets the information you give it.

“So you say you have a back pain, and they try to type back pain into the computer, and the computer wants to say back ache, and you say, well it’s not really an ache, it’s a pain, it’s a sharp shooting pain, and they have a hard time mapping what the patient says to what the codes are in the computer system.”

Dr. King says it’s possible that doctors will rely too much on the computer to make decisions.  Still, he says, humans have a special gift that computers don’t.

“When it looks like it’s supposed to be in the textbook, it’s easy as pie.  When it doesn’t look like it’s supposed to be in the textbook, it could get really difficult.  And that’s what you still need doctors for.”

From the KUHF NewsLab, I’m Melissa Galvez.