Electronic health records in the land of Gotcha!
There needs to be at least a hint of political scandal for serious public policy discussions to qualify as news these days. Which is why reports that patients in the UK’s national healthcare system might be granted some some say in managing their personal health records after the next election gets largely lost in discussion of close ties between Google and Britain’s Conservative Party. This is a shame, because public debate over the promises and perils of electronic health record technology are long overdue. ******The tempest concerns Steve Hilton, considered one of Tory party leader David Cameron’s closest aides, who is married to Rachel Whetstone, Google’s vice president of global communications. The suggestion in some reports is that these links will make it difficult for the party to include Google in any plan to give citizens the choice of storing their health records with private companies such as Microsoft or top UK private insurer Bupa. Google would have to get busy quick, as currently, its health records service is designed only for the United States. And it has had trouble gaining traction there. As an opposition party, the Conservatives’ views on the subject are relevant because they currently enjoy a wide lead in polls over who might win the next national elections.******Electronic health records could offer broad benefits, if ever implemented. But many issues must be resolved. The medical profession has long resisted adopting any plan that would help patients second-guess treatment decisions by their physicians. There remain vast problems with how to incorporate old medical records with any degree of accuracy into an electronic record. There are nagging questions about how to create common formats to share all the different types of information that might be included in a health record — from scribbled prescription orders to faxes to database records to X-rays and so on. There are commercial issues over how to balance the interests of patients, medical providers and “payors,” or insurers. Then there is the chicken and egg question of how to get these institutions involved and who will move first. Perhaps the most cripling issue is patient privacy and how to ensure that intitmate personal information is not released. ******In an April speech at the Conservative Party’s spring conference, Cameron spoke of replacing the National Health Service’s (NHS) centralized patient database with a distributed patient health record system that grants some powers to patients to manage their own information. He claims a private plan would “cost virtually noting to run”, in contrast to the Labour government’s £12.7 billion current upgrade of health information systems that does not include measures to give patients more control over their records.***
“People can store their health records securely online, they can show them to whichever doctor they want. They’re in control, not the state.***And when they’re in control of their own health records, they’re more interested in their health, so they might start living more healthily, saving the NHS (National Health Service) money.***But best of all in this age of austerity, a web-based version of the government’s bureaucratic scheme services like Google Health or Microsoft Health Vault cost virtually nothing to run.”
***Paul Stevenson, a spokesman for the Conservative Party on health policy, confirmed his organisation has commissioned an independent report by the British Computer Society looking at issues involved in implementing a more decentralised approach to electronic patient records. He declined to comment on specifics of the party’s plan, but said a response to the BCS report will be released in a few weeks time. “What the report does look at is how to move to a bottoms-up approach in NHS computing rather than a top-down approach,” Stevenson said.******The public’s attention span is never long for complex medical issues. Note the relative inattention paid to public health preparations since the global swine flu panic of April. As we head into the silly season of late summer news, expect medical privacy scare stories to reach a fevered pitch. The near-term prognosis is not good. ******(Images: TheInsider.com; Times Online; Google Health)