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US healthcare IT plan unveiled

US president George W Bush has unveiled a national healthcare IT plan focused on the development of personal electronic medical records and the appointment of a health care IT tsar to oversee the process.

Bush called the existing paper-based US medical record system antiquated and said "medicine ought to be using modern technologies in order to better share information, to reduce medical errors and cost to our health care system by billions of dollars". 

Bush added that "to protect patients and improve care and reduce cost, we need a system where everyone has their own personal electronic medical record that they control and they can give a doctor when they need to".

Lynne Royer, director of medical informatics at Community Health Network in Indianapolis, which operates five hospitals said Bush's plan provides high-level leadership for change in an industry that has "done the same things in the same way for too long a time". 

The White House said that the adoption of standards is key to development of a portable, electronic medical record.

Last July, the US Department of Health and Human Services (HHS) launched a programme to provide a standardised clinical terminology database to healthcare organisations nationwide. That database will serve as one of the building blocks of a electronic medical record. 

Standards will enable transmission of X-rays over the internet, aid transmission of electronic lab results and lead to the development of electronic prescriptions. 

James Mormann, chief information officer of the Iowa Health System, agreed that standards are "absolutely" essential to development of a national electronic medical record system since healthcare professionals and providers today cannot even agree on the definition of an electronic medical record. 

Standards are also essential for portability, Mormann said. Iowa Health has done about 70% of the work needed to deploy electronic medical records in its 10 hospitals. But that will not help patients who move to another state and check into another hospital that uses a different system from a different suppliers, he said. 

Royer cautioned that while developing an electronic medical record, the government and the industry need to view technology as a means to an end and not the end in itself. Besides applying technology to medical records, the health care industry also needs to build in workflow process change - otherwise the industry could end up automating a "paper process which is a mess", Royer said. 

Development of a standards-based national electronic medical record will not be easy or cheap, Mormann said. But "it is long overdue". 

Bob Brewin writes for Computerworld


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