Paperless Medicine
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Electronic Connections
As consumers continue to demand a bigger role in-and better quality from-their medical care, physicians will become more inclined to adopt electronic medical records. As they do so, benefits beyond those for individual patients will emerge.
Consider, for example, the national effort to beef up defenses against a terrorist attack involving biological agents. Should victims of a bioweapon begin to show up in hospitals and clinics throughout New York City, it could take days or weeks for physicians to realize that the patients at the various facilities were suffering from a single attack. Software designed to mine data from computerized records could spot the trend quickly, setting off alarms. Recognizing the power of the technology, in January the U.S. government announced a multimillion-dollar effort to use information gleaned from medical databases to monitor for disease outbreaks and bioterror threats in a half-dozen or so cities.The power of electronic records to connect the dots has implications far beyond the war on terror. As biomedical researchers discover more about the molecular bases of disease and the connection between genetics and health, medicine will become more and more dependent on volumes of data on individual patients. Medical records in the coming decade will incorporate not just demographics and medication histories, but also DNA sequences and gene expression profiles, which describe specific genes that are active in various tissues in the body. IBM Life Sciences, for example, has embarked on collaborative efforts to manage just such medical data in a pilot project with Hadassah Hospital in Jerusalem, Israel. IBM researchers have created an integrated medical record that contains such standard data as test results, physician observations, and lists of prescribed medications, as well as information on the patients’ genomes.
Health care will increasingly be a molecular-medicine view of health and disease,” says Masys. He cites as emblematic one research project that measures the gene expression levels in prostate tumors. Finding correlations between gene expression and the disease’s progression would enable doctors to provide more effective diagnoses and treatments but would require cutting-edge bioinformatics software. “The fusion of both computing technologies and biotechnologies is really the remarkable difference of our time,” Masys says. “If people look back a hundred years from now, they will see this dramatic turning point in human affairs with respect to health.”
Electronic records will enable that transformation, helping doctors make sense of mountains of data and enhancing the quality of health care. And now, with a big push from some of the nation’s biggest health-care providers, the technology’s stay in the waiting room may be nearing an end.
The Record Keepers
| Institution | Project/Technology |
| CareGroup Healthcare System (Boston, MA) | PatientSite, a Web site that gives patients 24-hour access to their medical records |
| Cedars-Sinai Health System (Los Angeles, CA) | Campuswide deployment of 802.11b wireless network, providing access to electronic records |
| Kaiser Permanente (Oakland, CA) | Implementation of electronic medical records and patient access for all 8.4 million members through a set of databases sharing a common interface |
| Regenstrief Institute (Indianapolis, IN) | Access through a Web browser to patient data for emergency rooms in 13 hospitals |
| U.S. Department of Veterans Affairs (Washington, DC) | Separate electronic medical-records systems deployed at all 163 VA hospitals and many outpatient clinics |
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