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Electronic health records -- clear necessity

My compatriots are active this week blogging about electronic health records.   And such records are a major part of my column to appear Monday.   So let me reiterate what I think are the basic points:

1.   The cost savings from electronic health records can be huge.   The US government estimate is $300 billion annually.

2.   So can life savings.  Those are harder to estimate.   Studies of deaths due to medical error tend to focus on things that health records wouldn't necessarily avert.   Still, estimates in the tens of thousands of lives saved annually in the US alone are defensible.  In fact, I agree with them.  Numbers in that range for the entire world are an obvious slam dunk. 

3.   Time savings and quality of life improvements for patients would surely be huge.

4.  They're not going to happen, and probably shouldn't happen, without strong privacy legislation.

The key is whether or not the privacy legislation makes sense.

What People Are Saying

Health care is what -- 1/7th

Health care is what -- 1/7th of the economy?  Yes, a lot of that is equipment, medication, and other supplies.   But look around at the labor the next time you're getting health treatment, and a whole lot of it is administrative.  That's especially if you combine billing kinds of administrative with records-routing kinds of administrative.  People primarily doing administrative work include some pure clerical folks (and even they are smarter/better than the average clerk, usually), all the way up through a whole lot of RNs.  Doctors are not exempt either.

The level of IT support for these tasks is TERRIBLE.  And the principal barrier to fixing healthcare IT is the records problem; other issues are no different in principle from those already solved in other industries.  So while I haven't independently validated the cost estimates, they sound plausible to me.  

The "preferential bias" point in your #3 makes no sense to me.   Your #4 also makes little sense.  We're talking about a specific technology, that might happen to need governent subsidies and/or other legislative support.  Trotting out every badly-thought-through recent law that has something to do with data collection, privacy, or technology in general doesn't seem relevant unless you spell out the point more clearly.

So that leaves us with the lives-saved point.   I'll let that one sit for now and see if anybody else weighs in first.

Umm. Can we examine some

Umm. Can we examine some aspects of your key points?

1. Government estimates. Our government (the US Government) consistently inflates potential savings (significantly) while just as consistently deflating potential costs. As a rule of thumb, take their cost estimates for savings and use them as the expense figure. Then do the same with expense figures for savings.

2. Tens of thousands of lives saved EACH YEAR because you have someone's medical records from another hospital or doctor's office? I strongly suspect the underlying assumptions here. Signifcantly more evidence and exposure of the underlying assumptions here are called for.

3. "would surely be huge" -- this is purely an assumption based on preferential bias. An opponent can make the same statement in the opposite with just as much authority and validity.

4. The same kind of reasoning was made with regards to DCMA, HIPAA, the Patriot Act and similar legislation. Please never underestimate the power of our legislative branch to do the wrong thing in the wrong way with the best of motives and intentions.