Below is a report in The Irish Times re the economies of electronic health records. Having had a recent experience where a test result was not on the doctor’s screen, I can only concur. That the VistA system which Dr Carey cites appears to be open source, which would be a prerequisite in my opninion. This also means that it can be adapted to local needs, as the Finns and Germans have done. This from Wikipedia:
The four major adopters of VistA – VA (VistA), DoD (CHCS), IHS (RPMS), and the Finnish Musti consortium – each took VistA in a different direction, creating related but distinct “dialects” of VistA. VA VistA and RPMS exchanged ideas and software repeatedly over the years, and RPMS periodically folded back into its code base new versions of the VA VistA packages. These two dialects are therefore the most closely related. The Musti software drifted further away from these two but retained compatibility with the infrastructure of RPMS and VA VistA (while adding additional GUI and web capabilities to improve function).
The Musti Consortium “has also been active to transfer the M Technology and applications to new environments like Unix, PCs, PC networks as well as client/server environments.” This would appear to cut costs even further, and being a European implementation, might well be better suited to Ireland.
Given the experience with electronic voting machines, it would appear that the current government (March 2010) can be trusted to choose the worst possilbe option. To avoid disaster by default, a debate on the issue is of the utmost importance.
Electronic health records could cut costs by a third
The Irish Times, Tue, Mar 09, 2010
Thousands of man hours could be saved if the State implemented an integrated electronic system of patient records
THE COST of administrating the health service could be cut by a third if integrated electronic patient records were introduced across the system, a medical conference has been told.
Currently there is no integrated system of patient records in the State, a situation which leads to thousands of man hours being spent recovering electronic and paper records.
Speaking at the spring conference of the Irish Society of Rheumatology last week, Dr John Carey said they could see three times as many patients if a proper electronic health information (EHI) system was in place.
Dr Carey cited international evidence which showed that one in five laboratory tests was repeated and one in seven hospitalisations was carried out unnecessarily because patient records were not found in time.
In Galway University Hospital, where he works, there are 20 different sets of health records in individual specialities.
Dr Carey said the integration of the health system into a “single seamless system” was achievable with modern technology and broadband and would pay for itself many times over after the initial investment, although he said he hadn’t costed the initial set-up.
He cited the Veterans Health Administration (VHA) in the United States, which administers the health of four million US veterans, as an example of best practice in this regard.
It has a widely praised system called VistA which is accessible to health professionals with secure passwords.
“I’m in favour of a universal system that everybody from GPs to consultants can use and we can look at what we are all doing.
“It takes time. If it is done well, it has great advantages; if it is done badly, it creates more problems,” according to Dr Carey.
“You should be able to access it from anywhere and see that information is accurate.
“There are huge savings in terms of finances, efficiency, etc,” he said.
US President Barack Obama made an integrated system one of the pledges of his presidential campaign.
Consultant rheumatologist Dr Robert Coughlan told the spring conference that having an integrated system would be good for patients because doctors would have immediate access to the relevant details.
He revealed that an e-clinic to be set up in Roscommon Hospital, which is connected to Merlin Park University Hospital, would enable rheumatology doctors to collect about 90 per cent of the information they need without physically seeing the patient.
It will also save patients long bus and car journeys from all over the west of Ireland to visit the hospital.
“There is no reason why this kind of practice should not be rolled out in all specialities nationwide with the support of private initiatives and the HSE,” Dr Coughlan said.
© 2010 The Irish Times