What the electronic medical record movement needs

The march toward automating health records goes on. (Image of stick memory from MedicAlert.)

New York has set a goal of getting its basic records online by the end of this year. That's patient charts, referrals, and prescription data.

Medical groups are already touting the benefits, like the ability to quickly change prescriptions in the wake of news, such as today's bad news about drugs like Zetia and Vytorin.

But advocates of a quick move to automating medical records, like Tim Holland, bemoan a lack of leadership on the question.

Is leadership really the problem?

I don't think so. Not in the way we normally define leadership.

I think the question is one of standards. Not just technical standards, like file formats. But standards for what types of records need to be computerized, and when. Along with standards on who will pay for the transition.

Critics will deride any set of standards as a mandate. On this they're right. So the scope of the mandate -- its cost -- needs to be set, and payback assured, before we move forward.

That doesn't take leadership so much as it does consensus.

Any automation of health records will carry advantages. If my doctor has a computerized chart on me, the payback is immediate if (God forbid) something happens to him. Or to me.

Right now millions of patients are trying to avoid this liability by wearing basic chart information in case of accident. That's what a MedicAlert bracelet really is.

OK, so that's the client. How do we get that on the server, and into the cloud? How do we assure the reliability and security of that information? How do we update it?

These are primarily technical questions, but they are very basic questions. What's needed before they're answered is a consensus-based planning exercise, answering what data needs to get online first, what goes online next, and how will it be stored.

These are questions vendors can help answer, if they use this medium to get together with their own medical experts and negotiate answers. We don't have to wait on government to mandate a kludge.

Are you listening McKesson, Microsoft, IBM, Oracle? Are any of you listening?