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TR: You mean lose him or her to a competing hospital.

DB: That’s right.

TR: The Institute of Medicine has said that between 44,000 and 98,000 Americans die every year from medical errors of various kinds, and that IT can help. Are patients dying because of a lack of information exchange?

DB: Patients are suffering because necessary information is not available at the point of care. With robust health-­information exchange, there can be improved quality of care and improved care coördination. Today, the average 65-year-old with five chronic conditions has 14 doctors and is on multiple medications.

TR: Do any technological barriers, such as conflicting standards, stand in the way of these hospital exchanges? Would we need to give everyone a national health-care ID to properly merge or reconcile their records?

DB: No. I think we have almost all the standards we need, but we have to get people to use them. And we can do this without a single health-care ID.

TR: Why not a single health-care ID? Wouldn’t that make things simpler?

DB: We have a big job ahead of us to achieve widespread adoption and meaningful use of electronic records. We can get to where we want to go without a single health-care ID.

TR: Was the changeover to electronic records difficult for you personally?

DB: At some time over the last 10 years, I was basically required to use electronic records. I learned it gradually over time. As I got more capable, I became increasingly convinced of its value in clinical care. It was making me a better physician.

TR: How, for example?

DB: A couple of years ago, I saw a patient with a urinary-tract infection. I entered the order for Bactrim [a sulfa drug] on my computerized physician-order-entry system–and a warning came up saying this patient is allergic to sulfa. I am sure in the paper record there was a record of that, but it’s often easy to overlook things in a voluminous paper record. That kind of gain, repeated hundreds of thousands of times across the country, can result in real improvements in care.

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Credit: Chris Crisman

Tagged: Computing

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