Idon't often quote George Bush, but he was right when he pointed out in a 2006 presidential discussion on health care that "doctors practice 21st-century medicine, but they still have 19th-century filing systems."
Patients often wonder, "How come the Instabank in Istanbul tells me exactly how much money is in my account, but my doctor doesn't have access to that test I did down the street last week?"
Many of you use a 21st-century filing system called Google, relying on its e-mail program or its maps to navigate your life. Now, Google is trying to help you track your health.
Last month, Google announced it is pilot testing its own electronic health record with up to 10,000 volunteer patients at the Cleveland Clinic. An EHR is a digital version or your personal medical record. These records exist, in some form, in the offices of some family doctors, hospitals and labs, but there is no common standard.
In a perfect world, an EHR would create a seamless pathway to share your health information across the continuum of care between your family physician, specialists, labs, hospitals and other health-care providers, no matter where they were located.
When I think of Google I think of simplicity, subtle advertising, "cyberchondria" (an Internet-induced fear of a terrible diagnosis) and cool innovation. When I think of Google in the context of an EHR, I feel both revulsion and attraction. On one hand, my inner conspiracy theorist worries about one of America's biggest corporations having access to personal medical data. On the other, the riddle of building a universal EHR has thwarted major corporations and governments worldwide and I can't help but think that Google stands a pretty good chance of creating an elegant solution to a problem I see every day: not having all the facts about a patient at my fingertips.
When we think of holy grails in medicine, we tend to think of cures for cancer and miraculous surgical recoveries. But for many experts in the Canadian health-care system, the biggest grail is a universal EHR.
Imagine a world in which I wouldn't be allowed to prescribe a medication for you that you reacted to 15 years ago; where the smartest pediatric neuroradiologist was looking at your child's MRI while held her hand in a rural emergency room; where health interventions could be measured in real time.
These things do happen to some degree now, but in isolated experiments and not in a networked or national way.
Google's EHR is in its early phase and won't make all of that possible, but it will start to organize your data from tests to X-rays to doctor's visits, and it will interface your medications with a database to let you know about any drug interactions.
Can Google translate its success in helping me locate the arena where my kid's hockey game is into helping you map your health history?
Michael Guerriere, managing partner of the Courtyard Group, an international consulting firm that helps institutions overcome challenges in electronic health records, also has mixed feelings.
"If you had asked a banker or a travel agent in the '70s whether it was a good idea that people enter their own transactions or book their own flights, most would have said no," he says. "Yet most industries today have been transformed by serving clients online and giving them hands-on control of their own transactions. Google and others are trying to apply this idea to health care, which is good. On the other hand, I believe health care is much more complex than these industries. It has taken 15 years to understand how to best display information to clinicians that is meaningful. The same might be true for the general public."
