Sen. Whitehouse joins Gingrich in push for electronic health records
1:14 PM Tue, Oct 28, 2008 | Permalink
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By John E. Mulligan WASHINGTON -- Sen. Sheldon Whitehouse has joined former House Speaker Newt Gingrich in calling for better health care through computer technology. In an opinion essay published in today's Washington Times, the bipartisan pair said the new president and Congress should make it a top priority to create a national electronic health care system during the next four years. Gingrich, a Georgia Republican, led a sea-change in congressional politics by helping the GOP to take control of the House of Representatives in 1994 for the first time since the 1950s. In retirement, he has made a pet project of health care "IT'' -- or information technology -- often joining forces with Democrats. Gingrich has appeared, for example, with Rhode Island Democratic Rep. Patrick J. Kennedy to speak out for computerization of health records. Rhode Island Democrat Whitehouse has also made medical information technology a personal goal. "Health IT should be what railroad tracks were for transportation 150 years ago: basic infrastructure,'' wrote Whitehouse and Gingrich. "A modernized, interconnected health system that electronically links patients, physicians, hospitals, pharmacies, public health agencies, payers and key emergency responders would allow all to share accurate, patient-protected information, and that will undoubtedly save lives and save money.'' They ticked off a number of problems in the current medical system, including high U.S. rates of infant mortality and obesity, poor efforts at preventing health problems, and a coming shortfall in Medicare and Medicaid financing that has ``catastrophic implications'' for the federal budget. But the "first and foremost'' goal for medical reform must be "serious investment in health information technology,'' they wrote. 
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Having experienced the Electronic Medical Record as a doctor I found it cumbersome, obsessed with minor,irrelevant details and time consuming. It interrupted my usual rapport with patients as I pecked on the keyboard. The (often irrelevant) prompts and data fields interrupted my flow of thought. I would usually take a few notes and then spend my evening at home dutifully filling in the blanks. EMR added about 30% extra work compared to a visit from the pre-EMR era. I went into medicine to think not to perform as a clerk-typist. Given the meager compensation for primary care, it was an unwanted significant expense. The present EMR systems are not ready for prime time and do not achieve the "intercommunication" they tout. My proprietary system cannot talk to your proprietary system. They seem designed primarily to facilitate billing (which the insurers and government make as complicated as possible). Unfortunately Primary Care physicians have acquiesced and accepted their new role as bean counters and secretaries. The currently available EMR systems are at the stage of development that color TVs were in the 1960s or mobile phones in the 1980s. Perhaps in twenty years there will be a system which performs as advertised. Primary care is hard enough without putting obstacles between the patient and doctor. I note that the most vocal advocates of EMR are people who don't take care of patients. Doctors are professionally trained to use their brains to diagnose and treat problems. Only 2% of recent medical grads chose primary care as a career. I suspect these cumbersome electronic documentation systems contribute to that aversion.
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