Computer medical records

I rarely read the AEI WSJ op-ed page, but today there was an interesting op-ed against computerized medical records by a pair of doctors. The argument is that current implementations of electronic medical records have not improved care or costs; therefore, projections by RAND of large potential savings are dubious. This is probably true, but it is exactly the kind of short-sighted argument one typically faces with any new idea. The problem is that current implementations are poor copies of paper medical records. Without more intelligence in the software and wider infrastructure (i.e. connections with other doctors, hospitals and insurance companies), electronic records can’t improve anything. Read Uwe Reinhardt posts that explain some of the problems with medical care. The two big ones are (1) doctors frequently deliver incorrect or inefficient treatments and (2) different regions and hospitals charge wildly different amounts for the same treatments. A goal of electronic medical records is to reduce these problems by (1) reminding doctors what the typical treatments should be and (2) easily pinpointing hospitals/doctors that are overcharging for procedures. Another potential savings is to reduce some admin overhead, which is one significant reason the US costs so much more than comparable countries. Any guess at potential savings can be easily criticized because it is just a guess. But the history of the computers’ impact on different industries makes me believe any estimate of future savings will fall far short of reality. We can’t get there unless we start today.


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