Digital Health Records: Not So Fast

  • In a pitch to revive the economy by cutting medical costs, president-elect Obama plans to computerize the nation's healthcare records in five years. Doing so would ideally improve the quality of healthcare for all Americans, yet what about those of us with SZ or mood disorders or other MIs?

    In practice, curious eyes could wander from your electronic diabetes information and surf over to your mental health record. If you think this is far-fetched, be assured Big Brother is watching us even with today's pen-and-paper recordkeeping. Elyn Saks, the law professor I interviewed here when her SZ memoir was published, has stated in her public speaking gigs that a doctor refused to perform life-saving surgery when her medical records revealed her SZ history, claiming she was making up her story. The kind of operation she needed-if delayed-had a 50 percent chance of the patient dying from a fatal brain hemorrhage.

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    In theory, modernizing everyone's health records would "cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests," according to Obama. He suggests, "It will save lives by reducing the deadly but preventable medical errors that pervade our healthcare system."

    Medical errors are made by humans, and human errors will abound even with improved technology. Do I want my cardiologist when I explain my chest pains to find out I have SZ and tell me it's all in my head, I'm a silly woman and I've having a bout of anxiety?

    My mother went to the hospital complaining of stomach pains and she was sent home, only to be gripped with such intense cramps a half hour later that my father drove her right away to a different hospital closer to their home, not knowing if the health plan would cover it. It turned out she needed her gall bladder removed-she was not having heartburn.

    Will a cornucopia of readily available information about every aspect of our mental and physical health actually improve decision-making? Hopefully, doctors won't be able to ignore glaringly obvious health concerns when they see them on a computer screen. The completeness of the actual records isn't a guarantee, though.

    What happened to me seven years ago: I had to diagnose myself as being at the highest risk for heart disease. I'd seen a male doctor on the Island-I call him Dr. Fox-who would test my blood but never call to give me the results. Something happened, I needed to see him, and I forget why, and he did his usual job of prancing around doing nothing. My mother phoned him and accused him of taking advantage of me because I had SZ.

    Needless to say, I had to find a new doctor, so I wrote Dr. Fox requesting he send me the last five years' worth of blood test results. Reading them over, I saw that the documents repeatedly stated I was at the highest risk for coronary artery disease because of my wacky c-reactive protein-a fact he never once told me although heart disease is the number-one killer of women.

    So it comes down to judgment and interpretation: could a doctor see your electronic records and still not take the right action, even though the results are staring at him in black-and-white? By the way, I left Dr. Fox and now see the famous Dr. Krall I've written about in here; she tests my blood every three months because of my elevated risk and also because I'm on Geodon.

  • At first, I wasn't so concerned about the switch to digital health records because to me, I'm out, it's no big deal, and I refuse to live my life in hiding, under a cloak of secrecy and shame. Yet the reality is-and it's a big if-what if universal access to your health information could violate privacy laws and result in far greater medical errors, as seen by the treatment Elyn Saks received because of her SZ?

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    I'm a fan of nationwide electronic health records only if they are used-and used wisely. It remains to be seen if they will.

Published On: January 14, 2009