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Politics is a process by which groups of people make collective decisions

By Francisco Rodriguez Higueras

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Published: 20Feb2010
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Included in the $787 billion stimulus bill passed earlier this year is the requirement that all medical records be transitioned into electronic files, doing away with the pen and paper charts doctors have historically relied upon. Sure it sounds good, but please, let's think about it realistically.

When this transition is complete there will certainly be success stories for plan architects to tout to the public. However, what happens when the computer system crashes? I'm not talking about just the national system mind you, but the system in your doctor's office?

Secretary Sebelius and Vice-President Biden recently announced grants totaling $1.2 Billion to reimburse doctors and medical facilities for the cost of making the switch from paper to electronic files for all medical records. As is usual with bureaucracy business, the specifics of the actual requirements to qualify for reimbursement are a bit fuzzy. Did we learn anything from Cash for Clunkers?

Obviously, if the national system goes down, due to hacking, east coast blackouts, human error, software or hardware issues, we will be in a world of hurt. What happens to patients awaiting a critical test result prior to the administration of life-saving medication, or a pathology report needed to direct the surgeon's scalpel, should the system decide to blink? Can you hear a mother pleading with an emergency room doctor to "Help my child!" only to be told the computer is running slow today?

Last year I went to the dermatologist for my annual check-up. I have a history of small skin cancers, so I keep that appointment religiously. However, when the nurse entered the examination room I was told their "system was down" and there was no access to appointment records or patient charts. The nurse asked me, "Why are you here today? What have you been seen for in the past?" Obviously, this physician practice has already made the transition to electronic files.

Okay, let's be fair. If you take your child to an emergency room far from home their records won't be available at a moments notice anyway. But, circumstances usually take you to the emergency room nearest your home. And, there is always the telephone...

How many times have you been totally frustrated because you were unable to complete a task due to a slow or completely fried computer? What will happen if such a system failure occurs when a life and death medical record or test result is hung up?

The more complexity we build into our systems, the more we rely on technology. It can be a wonderful thing, but are you willing to bet your life on it? Aesop taught us that "slow and steady" wins the race. Let's think this through and get it right the first time.

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