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    Monday, November 07, 2005

    The Big Plan: Meet the man whose job it is to nationalize healthcare records. Good luck with that. The article leaves the impression that doctors and hospitals are going to have make the large payout to invest in the computers and software, but all of the monetary rewards will be reaped by insurance companies, Medicare/Medicaid (i.e. the government) and corporate America. (Also see this graphic.)

    Much of the promise of computerized records is being over-hyped. Yes, it's a more efficient method of storing and retrieving information. And yes, it's a method of reducing errors, although it also introduces new system-specific errors. The government's paramount goal in pushing a nationally-connected healthcare record is to be able to monitor and prescribe what kind of treatment everyone gets. You might be 85 years old and not want a mammogram, but too bad. The system will make sure you are harassed until you get one.

    Something like this happens already with insurance companies that have "disease management" programs. One of my patients was enrolled in one for diabetes, but along the way he developed liver failure from cirrhosis. He was so malnourished from his liver disease that he no longer needed his diabetic medications and it was a total waste of time and money to order his diabetic labs. But, once a diabetic, always a diabetic, and I couldn't get him disenrolled. They kept bugging me and bugging me for his labs until I just did them. And every time I filled out their forms, I would write on the bottom - "patient severely malnourished from end-stage liver disease." It didn't matter. They didn't care about the patient. They just cared that their parameters didn't set empty in their database.

    Count me unconvinced that computerized records will be the savior of medicine. It's just managed care in another guise.
     

    posted by Sydney on 11/07/2005 08:08:00 AM 0 comments

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