As he looks for ways to pay for universal health coverage, President Barack Obama is placing a multibillion-dollar bet on electronic health records.
The goal is to get all of the nation's doctors to make the move from clipboard to computer by 2014, thus creating a national health information network that proponents from across the political spectrum say will improve care, advance medical knowledge and save the country tens of billions of dollars annually.
That future can be glimpsed in Dundalk, where H. Edward Parker has been a patient at Johns Hopkins Community Physicians for decades. Now the retired high school principal sits down next to his doctor as they use a computer program to review his history, look up the latest research and discuss new courses of treatment.
"We have much more meaningful communication" since his doctor's office adopted electronic health records in early 2007, Parker said. "It has made me much more of a participant in my own wellness."
Obama has promised to spend $50 billion over five years on health information technology and fulfilled more than a third of the pledge with $17.2 billion in the economic stimulus package to help doctors with the costs of adopting electronic records, the foundation of the national network.
"We've got the most inefficient health care system imaginable," Obama said last month. "We're still using paper. We're still filing things in triplicate. Nurses can't read the prescriptions that doctors have written out. Why wouldn't we want to put that on an electronic medical record that will reduce error rates, reduce our long-term costs of health care and create jobs right now?"
The enthusiasm is not unanimous. Privacy advocates warn that the characteristics that make computerizing patient records attractive to health care providers - the wealth of personal information and the ease with which it can be accessed - also make the technology ripe for potential exploitation by employers, insurers and others. There is already a market in which medical data, typically gleaned from insurance records, is bought and sold.
"The problem is that the more data that's out there - and it's just going to mushroom - the more difficult it is to keep that private," said Ashley Katz, executive director of the watchdog group Patient Privacy Rights. "Yes, we can do really, really great things with health [information technology]. We can also do really bad things with it."
