COMPUTERS AND CARE: New Technology Shapes Medical Future
The medical community is rapidly changing to computerized records, or medical informatics. The changes are revolutionizing the way medicine is practiced, resulting in a paperless, filmless, inter-connected system. Although advancing at different speeds, many state hospitals already rely on new technology for daily activities. The San Bernadino-based Community Hospital has relied on a computer-based system since 1997 that records, stores and transmits patient data, reducing the need for often cumbersome charts. Nurses, physicians, case managers and authorized staff can log onto the system to find out what treatment a patient is receiving. Scott Browar, vice president of clinical services at the facility, said, "Medicine's complexity and specialization make it more essential than ever to work as a team. And computers facilitate this." Arrowhead Regional Medical Center in Colton is planning on computerizing every piece of patients' clinical information so that health care providers can have instant access to lab results, prescriptions and medical histories at terminals throughout the facility. Plans to convert to a completely paperless system are under way at Loma Linda University Medical Center as well. Spokesperson Bob Blades said, "We want medical care to be a good experience, not frustrating or aggravating. Good healing comes with good care. So our focus is to build a system that's seamlessly integrated."
Not So Fast!
While many agree that computers can streamline and improve patient care, there are still several concerns with the advanced technology. Some believe that the switch to a completely computerized recordkeeping system will hold down costs, while others fear that the price tag associated with implementing and maintaining the advanced systems nullify any savings. Summing up the cost issue, Dr. Lee Ewin, a computer systems analyst for Kaiser Permanente Medical Center in Riverside, said, "The ultimate impact of computers on health care costs is unknown. But they will undoubtedly improve care." In addition, Dr. Kali Chaudhuri, CEO of KPC Global Care, believes that computers will be a vital tool in assisting physicians when making financial and clinical decisions. Chaudhuri said computers will ultimately provide "quality care consistent with the financial budget [physicians] operate within" (Schwartz, Press-Enterprise, 1/4).
Another major concern, particularly for patients, is the confidentiality of such electronic records. While computerized data provides health care workers with instantaneous access, any break in security can afford similar access to unauthorized users. Ewin said, "If people can access or hack into a system, they can review records much more quickly and comprehensively than with traditional hard copies." Traditionally, users need to have a password or some type of authorization card to gain access to information, but rapid advancements require more sophisticated security measures like scanning fingerprints or the eye. A California law that took effect on Jan. 1 has closed some of the confidentiality loopholes by establishing stronger penalties for improperly disseminating patient information. However, patients still go to great lengths to ensure that the medical records remain private, according to Beth Givens, director of the not-for-profit Privacy Rights Clearinghouse. A 1999 California HealthCare Foundation survey of 1,100 state residents found that one-in-six had in some way acted to prevent the misuse of their health care information. Givens notes that public concern over privacy is likely to increase as more records become standardized. She points to the 1997 Health Insurance Portability and Accountability Act as a sign that a national medical database is "closer to reality." Enacted in July 1997, the law requires all health plans, providers and health information clearinghouses to use simplified national standards for electronic administrative and financial transactions. However, that law also required Congress or HHS to devise regulations to protect electronic medical information. The deadline for the regulations has been extended and will be an issue once Congress reconvenes (Schwartz, Press-Enterprise, 1/4).