Another Thought on Electronic Records

Alright, I'm going to say this and then I'll finally shut up (for at least a little while) on healthcare.

I think electronic records are very important.

Now there are two impediments to widespread electronic records, and they're related. The first is privacy - people want to make extra extra sure no one can take a look at their medical records, that the privacy is maintained. Largely because of very strict privacy regulations, electronic records are much more expensive to implement than they ought to be.

I don't quite understand the privacy thing. Sure, the records should be private, but the harm of that information getting out is...what? Aside from the fact that most people are almost too ready to tell you about their medical travails in excruciating and unsolicited detail, what's the motivation? And what can they do with it?

Sure, teenagers may not want their parents to know they had an abortion or someone may not want their employer to know they have aids, but most employers and parents are supremely underqualified to hack into even the least guarded systems. The odds of someone who could hurt me with my medical information having the skills (and motivation) to look at the results of my pap smear are infinitesimally small as opposed to, say, the benefits to getting all of my bank account and credit card information, which they can do by hacking into my bank - and, what do you know, all banks manage to use electronic records. The only real motivation I can see is to try to sell you tailored medical supplies, but I fail to see how that's more irksome that the omnipresent "increase your manhood" and "drive the girls crazy" and cialis spam. (I have no interest in increasing my manhood, thank you).

Ironically, the folks that can do you the most harm with your medical information are the ones we give it to: health insurance companies. They DO use that information to up premiums and refuse coverage.

I've mentioned reasons why I think it's important on an individual basis for us to have electronic records, but there's another potential use that we could use to our advantage (instead of for the health insurance company's advantage as it is currently being used): real statistical data.

Right now, effectivity of a drug is determined by clinical trials, usually run by the drug company. Ideally, they'd have a large base and run double blind controls, etc. etc. But there have been many instances where the tests were not as extensive or as objective as they could be - which shouldn't be a surprise. Big pharma is a multi-billion dollar industry and a promising new drug can make billions by itself.

But, statistical (anonymous) data were automatically captured and sent into medical databases that anyone could use, we could see real trends rather than arrange for a group of people to test theories. We could see if a drug wasn't working as planned or if it caused a statistically significant jump in some other condition as a side effect much more quicky and more objectively than anecdotal evidence sent in to the FDA or drumming up a class action suit that may or may not have any real merit.

In fact, that might be a fine way to screen class action suits (as part of tort reform) before they cost the accused a dime - if they don't meet a certain statistically significant threshold, the class action suit is thrown out. No more settling for millions to avoid the publicity whether there is merit in the accusation or not. But the suit is also much easier to prove with the objective evidence to hand.

But it's bigger than big pharma. We can check the efficacy in real world conditions of different treatments and diets and regimens. We might be able to find other factors that lead to heart disease and autism, that trigger cancer or obesity. We might change what we know about our tools and tests. Because that information is already there - we just don't have a comprehensive way of accessing it for our good.

Believe me, that information has been accessed to our detriment by those most likey to profit by it. Wouldn't it be nice to have it collected for our good?

And that's why I think electronic records are worth the trouble, worth the risk, worth even subsidization to have.

Now, the Mother can step in and explain why I'm all wet.