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E-medical records: What seems to be the problem?

There are lots of challenges, but financial disincentives may be the biggest.

July 14, 2008 12:00 PM ET

Computerworld - This version of this article originally appeared in Computerworld's print edition.

It's been about three years since San Diego's five major hospitals first convened to discuss sharing electronic medical record data in an effort to improve diagnoses, reduce errors and improve the quality of patient care. The group held several meetings and entered discussions with a vendor as a possible corporate sponsor -- and that was that.

"It really didn't go anywhere," says Dr. Joshua Lee, medical director of information services at the University of California, San Diego, Medical Center, one of the participants in the EMR discussion. While the system would have had a clear public health benefit, it was not in each hospital's economic self-interest to pursue it. "The financial and oversight responsibility would fall on the medical centers, even though it's a very intangible benefit to the medical centers," says Lee.

Today, if a child who is a UCSD patient at the pediatric clinic at 7910 Frost St. in San Diego is admitted to the emergency room at Sharp Memorial Hospital at 7901 Frost St., the only way the ER doctor can view that child's known medical problems, allergies, prescriptions and other health data is by calling UCSD HealthCare, making a records request, and waiting for the information to be printed and either faxed or physically delivered on paper. Conversely, any treatments or medications given at Sharp won't be entered into the patient's EMR in the UCSD system. "It's not like we don't share on paper, but we don't institutionally share data," says Lee.

The situation in San Diego is the norm rather than the exception, but it doesn't have to be that way. "We have had the technology to do this for 30 years," says Shaun Grannis, medical informatics researcher at the Regenstrief Institute, an Indianapolis-based research organization that spearheaded a metropolitan health information exchange in its home city. One of the first U.S. regional exchanges, the Indianapolis system is used by 34 health care providers.

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