Saturday, February 28, 2009


Part of the President's stimulus program is concerned with electronic medical records, promising that they will improve care. The theory is, apparently, that any doctor who sees a patient will have access to the patient's previous previous history, and therefore will make more informed medical decisions. Certainly having access to an accurate history contributes somewhat to treatment decisions for a given patient, and to the extent that such records can be made reasonably available, we should make an effort to do so. However, the improvement in quality to be expected from such availablity is likely overstated. A much more significant factor is the continuity in care that a pateint enjoys over time with a single dedicated provider. Knowing a patient's allergies and previous history is not the same as knowing the patient. NOt all of the subtle and subjective information related to a patient's health will ever make it into a written record, no matter how thorough the effort at documentation.

Reforming the healthcare system to make it more data-intensive is not likely to improve upon the care that is delivered by physicians who spend time with their patients and form therapeutic relationships over time.

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