Overlooked In The Rush To Digitize Medical Records

The administration has made $45 billion available for doctors and hospital across the country to digitize medical records. This money, part of the government's stimulus plan, promises what amounts to a gold rush for major technology firms, who have begun competing to win those accounts. But Fred Schulte, senior reporter for the Huffington Post Investigative Fund, says some health care professionals wonder if the promise of electronic medical records has been exaggerated. Host Scott Simon talks to Schulte about the potential pitfalls.

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SCOTT SIMON, host:

The administration has made as much as $45 billion available for doctors and hospitals across the country to digitize medical records. Fewer than a fifth of our nation's hospitals and doctors currently use an electronic medical record system. This money is part of the government's stimulus plan, and promises what amounts to a gold rush for major technology firms who have begun competing to win those accounts.

But Fred Schulte, senior reporter for the Huffington Post Investigative Fund, says that some health-care professionals wonder if the promise of electronic medical records has been exaggerated. He joins us in our studios. Fred, thanks very much for being with us.

Mr. FRED SCHULTE (Huffington Post Investigative Fund): Good to be with you.

SIMON: Give us some idea how major companies are competing to win these accounts.

Mr. SCHULTE: Well, there's - as you mentioned, there's a sort of a gold rush going on. There's a company that has a Cash for Clunkers-inspired program where if you turn in your old equipment, they'll give you a discount on a new one. There's companies that are offering doctors interest-free loans if they buy, and you don't have to pay back any of the money until you get your check from the government. There's a stimulus tour; it's like a rock tour going around the country - the big bus convening doctors in groups and trying to sell them on the benefits of buying this equipment.

SIMON: And there are some companies with names that might surprise us that are getting into this market.

Mr. SCHULTE: Well, some of the biggest companies in the world - Microsoft, Dell, Google. I mean, I think all of these huge tech companies are very interested in the billions of dollars that is going to derive from all these various types of health care in cyberspace. I mean, there's any number of things that will eventually come along once everything is digitized that - there's cash registers ringing.

SIMON: The stimulus plan promises money to doctors who make the switch, right? How does that work?

Mr. SCHULTE: Well, it's not quite that simple. I mean, a doctor can get $44,000 in stimulus money for buying the equipment in his or her office. But you also have to make meaningful use out of it. That's what the law says, meaningful use. But the law doesn't define what meaningful use is. So the whole industry is waiting to see - and it should happen sometime early next year - what the government decides you have to do to be meaningfully using this equipment.

SIMON: A lot of your reporting suggests that even at a time the government is pushing this initiative, there are - there are some people in the health- care industry who will wonder if isn't being oversold.

Mr. SCHULTE: Well, there are many people that wonder just that. I mean, the studies are often conflicting about the benefits of it. And there are just a lot of people that think that the technology isn't quite there yet. The idea is great, and it's hard to find anybody that doesn't think that medicine needs to move into the modern age, into the computer age. But on the other hand, you have to make sure that the software doesn't do strange things and mix up patients and have other problems like that. And there have been cases of that.

One of the problems that some of the critics are talking about is that nobody really is keeping track of the number of times that there's some sort of glitch or something goes wrong and whether those are - those problems are causing injuries. Some of the critics want to see the federal government step in and begin requiring the companies that manufacture this equipment to report adverse reactions the same way that drug companies have to do.

SIMON: And are there people concerned with some of the security implications?

Mr. SCHULTE: Well, totally. The privacy issue is huge. I mean, as you move toward electronic medical records, one of the things that the government wants to do is set up a health Internet, so that medical information could be sent to doctors, hospitals, anywhere in the world. And a breach of that security, obviously, could subject people's medical information to eyes that you don't want looking at it. So there is going to be probably years of trying to work out the privacy implications of going online like this.

SIMON: Privacy implications being the doctor-patient relationship is considered inviolable, and there are people who are not doctors, or for that matter patients of those doctors, who might figure out a way to get access to that information.

Mr. SCHULTE: That's true. And there's two issues, too. I mean, the first issue is who has control over the medical information and a medical record. And as we move to digital formats, it's not the same as a paper record being stored in a doctor's office. And many consumer groups want to see patients actually have control of that information. Then if you send it across the Internet, you want to be sure that it's being sent to somebody that you want it to be sent to, and not being used for commercial purposes or some other thing that you don't want to see happen.

SIMON: What are the implications for a hospital or a doctor to choose the right system?

Mr. SCHULTE: They're huge because there's a lot of taxpayers' money involved -as you mentioned, some $44 billion. It's a very difficult choice to make because there are lots of different types of doctors with a lots of different needs in their practice and lots of different equipment. And some of that equipment has a history of not working too well. A lot of doctors feel they're kind of at the mercy of these vendors and their salespeople that are coming out and telling them, oh, this system is great and whatever, and then they go out and buy it, and then they have all kinds of bugs and problems with it. And the taxpayers, obviously, have a side in this because if they collect the stimulus money, it's our money.

SIMON: The hope is, isn't it, that competition brings down the price, stimulates innovation, and that's ultimately good for patients, consumers?

Mr. SCHULTE: You mean for buying the equipment?

SIMON: Yeah.

Mr. SCHULTE: That would be the hope. But the critics are saying that when you go out and saym we're going to give you $44,000 to buy this, then the price is going to be 43,999, and there's not necessarily going to be a lot of incentive to get the prices down. Although some of the critics are saying there's a lot of new equipment coming onto the market that's much, much cheaper than that, and the taxpayers might save a lot of money if somebody decides which of these systems work the best, and then everybody went with that.

SIMON: Fred Schulte, senior reporter at the Huffington Post Investigative Fund. Thanks very much.

Mr. SCHULTE: My pleasure.

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