Digital Medical Records

Dr.  Paul Felden, a primary care physician stands amid his labyrinth of patient records, isolated in his offices in Mount Laural, NJ (picture taken from http://www.nytimes.com/2008/06/19/technology/19patient.html).

The problem is many patients see more more than one doctor, each with their own isolated room of medical records.  It is a very Web 1.0 world in the medical field.  Intertextual between doctors is complex and cumbersome.  A cancer patient who receives care, consultations, and treatments may interact with a number of health care professional including doctors (primary care and specialists), nurses, psychiatrists, insurances reps, and so on.  All of them may be looking at isolated medical records that could only show pieces of the puzzle.  

Not to mention the trouble for doctors.  In aforementioned article, journalist Steve Lorh writes "Dr. Paul Feldan, one of three doctors in a primary care practice in Mount Laurel, N.J., considered investing in electronic health records, and decided against it. The initial cost of upgrading the office’s personal computers, buying new software and obtaining technical support to make the shift would be $15,000 to $20,000 a doctor, he estimated. Then, during the time-consuming conversion from paper to computer records, the practice would be able to see far fewer patients, perhaps doubling the cost." 

Recalling a previous post, new digital recording technologies come with an inherent cost vs benefit analysis.  Is the time and money used in learning and installing the system into the everyday practice of the worklplace actually worth it?

The idea is getting more traction with recent attention on Health Care Reform.  Parts of the bill may include tax breaks for doctors who switch to digital records.  Right now, not many are arguing against the need for digital records.  They arguing over who is going to pay for it.  

But, there are still questions about how this system will look, work, and feel.  I believe questions of interface and functionality have to be addressed before these plans go on ahead.  There is some suggestions that digital records will exist in a cloud-based system that has records on the internet, which will elements of genre system.  

In fact, web 2.0 culture beckons the idea that collaboration has to occur for production to be effective and collaboration has to be accomplished through a system of genres.  So, and I'm just speculating here, we might see patient records that include, shared videos and photos, comments, and discussions between different doctors over treatments and procedures.  A 2nd opinion will look less than helpful compared to 3-4 doctor discussion on your medical records.