E-health records need Web 2.0 cure

For years, the idea of making health records electronic — for increased accessibility, reduced errors and portability — has exerted a near-gravitational pull on the government market.

So why hasn’t it happened already?

The Bush administration considered automating health records but concluded that the effort must be led by the private sector, said Dr. Michael Cowan, BearingPoint’s chief medical officer.

“Now it’s been five years, and there’s been little movement, so the next logical step is the one that President Obama is taking” with the American Recovery and Reinvestment Act, Cowan said.

“It’s been hard to build a self-sustaining financial case for electronic health records,” he said, adding that for an individual practitioner, the cost to implement the technology is about $40,000.

With government support, the effort might achieve critical mass, but health care practitioners’ reluctance is about more than money.

“As a hematologist and oncologist, anything I can do to help you can also kill you if it’s not done right,” he said. “So I take a heuristic approach to patient care. My problem with EHR is it makes me change my rhythm. It’s like changing a dance step; it can throw you off.” It’s a complaint he said he’s heard from other doctors.

It’s also where health information technology companies can help, he said. “The new wave in technology is in Web 2.0, in applications that allow social interaction. Every other market is on the Web, and that’s what health care needs to do. We need to get functions onto Web 2.0 and away from software applications.”

Web-based networking is cheaper and more efficient, and it can help solve some of the knotty privacy and security problems associated with EHRs.

“Google and Microsoft have changed the game,” Cowan said. The two companies have partnered on a pilot project to store electronic health records for as many as 10,000 patients of the Cleveland Clinic.

Health profiles will include information about patients’ prescriptions, allergies and medical histories. Patients will access their records using the same password they use to access other Google services, such as e-mail.

BearingPoint is tweaking its own Web-based EHR pilot project, Cowan said.

The current health care model — calling for an appointment, waiting, driving to the facility, waiting some more — won’t survive the millennial generation, whose members are becoming consumers of health care, he said. “No step in that process will be acceptable to them. They’ll demand that the process change to suit the way they’re used to interacting.”

He said they will likely seek a self-directed diagnosis using online resources, followed by a consultation with contacts on social networks and an e-mail conversation with their medical provider. “And at the end, they’re going to want that prescription delivered to their doorstep at least as fast as Domino’s can deliver a pizza,” Cowan said.

Changes at the user end won’t preclude the need for case management and process and productivity payoffs, said Joseph Doherty, executive vice president and group president of ACS Government Solutions. “First, it’s about the patients. But hospitals, clinics, other providers — they’re in business, and ultimately it’s going to come down to: Who’s going to pay? How are you going to prepare the documents for matching federal funds? That’s where an end-to-end solution makes sense.”

But ultimately, Cowan said, “the real value of health IT may be that it will let us tear down the parking lots and put up trees.”