Special Report: From the Commission on Systemic Interoperabilty — "Electronic Health Records"
A special report from the Commission on Systemic Interoperability (CSI) about electronic health records.
Rebillot: This is a special report on consumers and health information technology. I'm Kris Rebillot reporting for the Commission on Systemic Interoperabilty. Seventy-year old Keith Belcher is a diabetic on cardiac rehab following triple by-pass surgery. A patient with a large health care organization in California's Silicon Valley — he is a poster child for consumer satisfaction, thanks — in large part — to electronic health records.
Belcher: I can get all of my tests, my blood tests, all the workups, everything. They're just available. You go online, and, you know, put in your password, and they're there, and I can check not only the current e-mails, but all of the old e-mails, and all of the old tests and the test results.
Rebillot: Belcher and his wife retired to a rural town in western Oregon in 2002, some 600 miles from their primary care physician. When they couldn't find an available doc in the small town — they decided to stay with their Palo Alto-based physician. Trips to visit family in the bay area allow them to keep up with annual physicals — and the health care organization's on-line service makes for great continuity of care. Belcher stays in touch with his physician via e-mail — sending reports on his blood sugar levels, and tweaking his heart medication as needed. He's got a personal relationship with his doctor.
Belcher: I feel like I have somebody that cares. It's through this PAM online we can talk. It's much easier than I have ever been able to talk to a doctor before. For the slightest little thing, I can e-mail her on their website, and will almost always by that evening and no later by the following morning have an e-mail back from her with suggestions, or "don't worry about it," or whatever it takes. So from that point of view, I find it very easy.
Rebillot: Belcher and his wife are RV fans — concerns about his chronic conditions don't hamper their ability to enjoy life.
Belcher: When we're in Eastern Oregon, or we're thinking about possibly going to Lake Powell, I really feel kind of comforted in that I can get access almost immediately to my doctor, and my records, and my everything else just by stopping at a café anywhere along the line. And most RV parks have Internet connections now, and so it's, you know, fortunately, we haven't had to use it, but it's there.
Rebillot: Juanita Pahdopony-Mithlow doesn't have that level of comfort. A teacher at Comanche Nation College in southwestern Oklahoma, she's been hauling reams of paperwork to her medical appointments for years. She was diagnosed with an autoimmune disease called scleroderma in 2000, thirteen years after her symptoms first appeared. Her condition has now developed into progressive systemic sclerosis. Pahdopony-Mithlow receives care at a U.S. Public Health Service Indian hospital. She sees numerous physicians who work in a paper-based system. Having all her records available digitally would make life easier — for her and her doctors.
Pahdopony-Mithlow: With something like the now-called progressive systemic sclerosis, it affects so many different parts of my body. And I can't tell you what I'm going to be complaining about next, because it could be, for a period of time, I had my hair falling out in great gobs, and I had really long hair, but then I'm passed that now. I've had my arms so tight and my skin so tight, my fingers and hands so tight that I couldn't open a jar. I never know what's going to happen today. It might be an episode of diarrhea. I never know what is going to affect me next, but it seems like something that travels, travels and travels all over my body. And if it were centrally located, then I wouldn't have to go through, like right now, I'm talking to you, I have all my notes in front of me. I wouldn't have to do that over and over if there were such as thing as a localized, you know, localized information, one place.
Rebillot: Pahdopony-Mithlow relates one nightmare scenario that could have possibly been avoided if all hospital personnel were looking at a digital record. After a long bout of acid reflux " she went to get tested to see if there were abnormalities in her esophagus.
Pahdopony-Mithlow: They did the testing in the lab, and they did the test to me over and over and over again. And they said, "We can't understand." I overhead them talking. I thought they knew what I was there for. And they said, "Well, you know, we can't understand. It's not working." And then I asked them what was going on. Well, what happened, I had no in my lower esophagus I didn't have very much movement there to swallow, and so, and I said, "I have scleroderma." And they said, "Oh! That explains it! Of course." And they also ran and they talked to other people, and before I know it a crowd was, you know, like two or three people, and they said, "Oh, she's got, she has, so this explains it. Why we weren't, you know, we were having to do this over and over." Oh, that was upsetting to me because I really felt like I was on display there. I thought they should have known why I was even there for that, but apparently, they didn't have that part of the puzzle. So I had to do that particular testing of pushing that tube down my throat, down into my stomach at least three times before they could realize that. I was tortured that day. I still remember that.
Rebillot: The medical records adminstrator at the Indian hospital where Pahdopony-Mithlow receives care says plans are in place to roll-out an electronic health record within a year. This is Kris Rebillot reporting.
About This Audio Report
Reporter: Kris Rebillot
Sound Bite: Keith Belcher, Juanita Pahdopony-Mithlow
Topic: Electronic Health Records, CSI