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The News Journal (Wilmington, DE)
Dec 21, 2004
by HIRAN RATNAYAKE The News Journal
Delawareans to carry medical history in their pocket;
Card will give doctors round-the-clock accessIn the wee hours of the morning, a man crashes his car.
He is unconscious and rushed to a hospital. The emergency room doctors can't find any medical information on him. They perform a CAT scan, unaware he is allergic to the radiological dye used in the diagnostic X-ray procedure.
He suffers an allergic reaction that delays the doctors from working on him.
He dies in the emergency room.
If this scenario were to happen in the future, the Delaware Health Information Network would warn emergency room doctors not to perform a CAT scan, said Sen. Tom Carper, D-Del. During a news conference Monday at Wilmington Hospital, he and Rep. Mike Castle, R-Del., said Delaware will get $700,000 in federal money to start an electronic patient-information system for health care workers to use.
The intent of the network is to connect doctors with labs, hospitals, pharmacies and nursing homes, and eliminate problems that come from trying to obtain information from facilities that aren't open around-the-clock. Patients would have a card that authorizes health care workers to obtain medical information. It's tantamount to how companies access credit card accounts to check financial history.
"For too long, we have been trying to practice 21st-century medicine with 19th-century support," Castle said.
Other states are working on similar projects.
Joseph A. Lieberman, commissioner of the Delaware Health Care Commission, a public body working to provide better health care to state residents, said patients could have information removed from the card.
"Our major concern is privacy," he said. "I don't want information out there in the ether. We just have to make sure this system is secure."
Making sure the system is secure is "the time-old story," said Jamie Court, president of the Foundation for Taxpayer and Consumer Rights. The California-based nonprofit organization was established in 1985 to protect the interests of consumers.
Court said systems such as the proposed network are gold mines for drug companies, insurance companies, employers and eligibility specialists.
"Every system is safe until the data gets stolen or the system is abused," he said. "I think these types of systems are rife with problems."
Court said the only way the network would have some credibility is if in the event it were abused, heavy fines could be levied against the beneficiaries of the system - doctors, pharmacists and hospitals.
"This is a very touchy subject and very dangerous," Court said. "Any system has the potential for problems. It all depends how much control the patient has."
Gina Perez, project director for DHIN, said representatives from patient advocacy groups would be on the network advisory committee.
During the next nine months, the DHIN board of directors will use a yet-to-be-determined portion of the $700,000 to evaluate Delaware's health system.
"There are physicians who are really wired, and there are some that don't know where the on and off switch is on the computer," Lieberman said.
The board does not know how it will use the rest of the federal money, Perez said. Nor is it known who would pay to keep the system going. The system could be fully operational in three to five years.
"We need to make sure we give doctors a tool that they can make part of their practice," Perez said. "If it's a tool that isn't part of their business, they're not going to use it anyway."
Carper and Castle cited a 2000 study by the Institute of Medicine, a public nonprofit organization that provides science-based advice. The study said that medical errors, including lack of information, are responsible for between 44,000 and 98,000 deaths each year. The study has come under criticism by doctors who said the figures were exaggerated.
Contact Hiran Ratnayake at 324-2547 or firstname.lastname@example.org
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