Sunday, April 3, 2011

The Practical Effects of Backwardness

So Scientific American has word of a nice study about a community of Minnesotans who reduced their rate of acute heart attacks by 24% in a year. Time will tell if it’s sustainable, but it sure sounds good, right? This particular community isn’t the healthiest in the country, with 73% either overweight or obese. That’s an encouraging contextual note. So what can we do to sign ourselves up for the program?:
To help combat these steep cardiovascular risk factors, the healthcare system used another robust local statistic: more than 90 percent of people there have an Allina electronic health record, "which serves as a helpful surveillance database," Boucher said. So doctors were able to start quickly pinpointing individuals who were at high risk for a heart attack and help them better track their health by monitoring cholesterol, blood pressure and medication.

The benefits of technology. It’s hard to tell what percentage of Americans have electronic health records as it’s only slightly less hard to figure out what percentage of doctors use electronic health records for their patients. A while back, I quoted a Consumer Reports article that surveyed doctors in which 37% of respondents said they used electronic records, though there’s no indication as to how comprehensive their records are and how robust their technical abilities are. A slightly older New England Journal of Medicine study found that less than 2% of acute care hospitals had comprehensive medical records. A Commonwealth Fund study found this of the state of our electronic health records:

I’m guessing that far fewer than 90% of Americans have electronic medical records. In fact, looking at the description of this program—which seems to imply heavy data analysis—I’m guessing it falls under the “advanced IT capacity”, which makes the number even lower.*  We couldn’t replicate the conditions of this program even if we tried; it’ll take years before we can even think about trying this kind of thing out.

* To add another disturbing note: how many of these high-powered records are fully interoperable with other systems, and how many of them can be shared easily with other hospitals, doctors, etc.? It takes a village to raise a child and to do health care right the same thing is true.

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