NOTE: While the posts on this blog should generally be concerned with healthcare related issues, the current political situation in Washington along with pending healthcare reform render politics and healthcare inextricably bound. When looking at the current logjam relating to healthcare reform, I think that there are a number of inescapable facts. Although I am far from a political expert, it is possible that the inexperienced person may be able to suggest workable and proper solutions specifically because they are not constrained by the minutia of the political process.


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The End Game

Posted in News on February 9th, 2010

As we enter 2010, it is clear that the government seeks to move medicine from paper- based practices to digital format. In fact, the HITECH legislation is merely the government addressing security issues expected as a result of the move to digital medical records before the actual transition takes place.

The big question, though, is “why?”  Why should the government be so interested in transitioning from paper to computer/digital-based medicine and creating incentives for electronic health records (EHR).  The reasons that are given most frequently are that it will bring down the cost of providing medicine, will prevent mix-ups in various medications, will afford patients the freedom to visit a doctor and have their complete medical histories available to them in a painless manner, and will, hopefully, preclude people in hospitals from having to repeat their medical histories half-a-dozen times before a procedure, etc., etc.

I suggest that irrespective of the above mentioned benefits, there is one overriding benefit that is not regularly discussed but is of epic proportions.

The larger the pool of data that can be assessed regarding a disease, its diagnosis, its treatment, and the effects of various drugs, the better and more efficient the provision of care will be, thus taking a lot of the guess work out of the process. Medical care will no longer rely on a doctor’s gut instincts and will be based on more comprehensive and accurate empirical data.

One example of the efficiencies that can be reached relates to Medco Health Solutions which currently boasts service to 62 million members across the United States. As such, Medco has a very large database and has conducted a study using data from 17,000 patients. Half the group used Plavix and the other half used Plavix plus a proton pump inhibitor. The finding was that the latter group using Plavix with the proton pump inhibitor (heartburn medicine) experienced a 50 percent increase in cardiovascular events and a 70 percent increase in heart attacks. Subsequently, the FDA issued a warning to doctors and patients. This is but one example of what can be accomplished if medical data is assembled and various statistical calculations are performed so that a new body of empirical data is derived that can guide the provision of medical care in our country.

While the overall cost benefit of electronic health records is yet to be proven, logic dictates that if enough statistical information can be assembled, it will yield important information that will save lives.

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