When an elderly woman walked into the Howard County General Hospital emergency room a year and a half ago suffering from extremely low blood pressure, Dr. Walt Atha had a hard time figuring out how to treat her.
The woman's medical records were not on file because she had never been to the hospital before. "I just had to throw the book at her," Atha said, explaining the various tests he performed before discovering she had a rare disorder called periodic hypokalemia that causes potassium levels and blood pressure to drop dangerously low.
"If I knew that," said Atha, "I would have immediately brought an endocrinologist on board."
Time spent guessing at a patient's illness can prove fatal. That is one reason why health professionals from Howard County have begun a three- to five-year multimillion-dollar project to computerize medical records, eventually linking doctors to a countywide system that will give them instant access to patients' records. The system will also link hospitals, clinics, labs, imaging centers, nursing homes, insurance companies and patients.
Officials predict that computerizing medical records will reduce medical errors. Between 44,000 and 98,000 people die in hospitals each year because of medical errors, according to a July report by the Robert Wood Johnson and Markle foundations. The report also noted that poor access to patient information is directly linked to 18 percent of adverse drug effects.
"I think that electronic records would definitely decrease the errors drastically," said Victor Plavner, chairman of The Maryland/D.C. Collaborative for Healthcare Information, the group spearheading the project in Howard County.
Electronic medical records also give primary care doctors more comprehensive views of patients' medical histories, cut down on lost or incomplete records and enhance epidemiology studies, he said.
Computerizing medical records might not seem like a novel idea in this plugged-in age of e-mail and instant messaging. But in the world of healthcare, it's revolutionary.
About 85 percent to 90 percent of U.S. doctors use strictly paper-record systems, Plavner said. Paper systems are difficult or impossible to access, especially in emergency situations when a patient is unconscious or unable to provide the primary care physician's name.
And of the few electronic records that do exist, most are incomplete and not equipped for interoffice sharing, Plavner said.
Howard County has one of the most computer-savvy health care systems in the nation -- about 25 percent of doctors here have some kind of electronic system, Plavner said -- which is why it was chosen for the pilot project.
The first steps of the county project are already in motion. Computer technicians are working on a way to integrate the separate electronic systems of about 20 primary care doctors and specialists.
After that, doctors with paper systems will be put on an electronic system that will then link to a county medical-record "web."
Participation is voluntary.
"If you can get instantaneous access to medical records it can give patients better service and avoid duplication of services," said David Gelled, a Columbia physician who is participating in the project.
Not only are extra procedures tiresome for patients, Plavner said, but they are expensive. A third of the $1.6 trillion that the United States spends on health care goes to duplicative care or to care that fails to improve patient health, according to the Robert Wood Johnson and Markle foundations report.
"The system we have now is really not acceptable," said Richard Klieg, president of the Horizon Foundation, a Howard County philanthropy that is consulting with the Maryland/D.C. collaborative on the project. Klieg said that shared medical records, while requiring a huge monetary investment, will be beneficial to patients, doctors and insurers.
But there are two major setbacks: cost and privacy.
On average, it costs $30,000 for a physician to establish an electronic system, and $10,000 a year for maintenance. But according to the foundations' report, an electronic system would save the average primary care provider about $86,400 over five years. The Howard project will cost about $10 million to $12 million. Most of that money will come from grants from the federal government and nonprofit organizations, Plavner said. Getting the whole nation on board would be a multibillion-dollar project, he said.
The Bush administration recently showed its support by doubling the budget for health technology in 2005, raising spending to $100 million.