Editorial: Getting doctors to go digital

A pioneering investment at Allina.

Last update: September 29, 2007 - 4:48 PM

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A 2005 RAND Corp. study estimated that only 15 to 20 percent of doctors' offices and 20 to 25 percent of U.S. hospitals have computerized medical records. "The U.S. health care industry is arguably the world's largest, most inefficient information enterprise,'' the authors concluded.

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In this dazzling age of digital technology, you can buy stock with a mouse click, draw cash from an ATM halfway around the globe from your bank and even scan your own purchases at Menards. But drop by the local medical clinic, and chances are you will still find a nurse scribbling notes on paper and trying to read the doctor's handwriting. A Twin Cities doctor used to joke that his dog got better health care than he did because the veterinarian's computer at least knew when Rover was due for shots.

But the antiquated state of medical records is no laughing matter. A 2005 study by the RAND Corp. suggests that Americans waste at least $100 billion per year in duplicated medical tests, bad prescriptions and other waste -- not to mention errors and missed diagnoses -- because most doctors and nurses lack quick access to accurate medical records. "When you look at health services, compared to financial services, we're a decade behind," says Richard Pettingill, president and CEO of Allina Hospitals and Clinics.

Pettingill should know. Allina just won a prestigious national award for a pioneering electronic medical record system that will link its eight hospitals and 65 clinics, allowing staff and patients speedy access to vital data. It's an important achievement for Minnesota, and it holds important lessons for improving health care.

Allina expects to recoup its $250 million investment within four or five years by practicing better, more efficient medicine. Just this month, for example, an ER physician was about to order a battery of tests for a young woman admitted with abdominal pain, when he noticed she had just had the same tests at another Allina facility. The computerized record saved unneeded tests and let the hospital treat the patient faster. In time, computerized medical records could improve diagnoses by bringing all of a patient's health history together in one place and speed the adoption of best practices.

Despite these benefits, hospitals and clinics have been slow to make the technology investment, which is why public leadership is important. David Durenberger, a former U.S. senator and chair of the National Institute of Health Policy at the University of St. Thomas, points out that government-run programs such as Medicare and Medicaid -- which pay for about a quarter of all health care these days -- don't generally reward the clinics and hospitals for the savings that these costly investments produce or for delivering better care as a result. There's also a public role in setting a common technology standard so that Allina's computers, for example, can talk to Medica's.

Minnesota is beginning to tackle these challenges. This year the Legislature appropriated $14 million to help small and rural clinics make technology investments. This month, Gov. Tim Pawlenty announced a public-private Health Information Exchange that will let the state's major providers and health plans share some medical records electronically.

But by and large, the public sector has been behind the curve. That's not all bad -- private players should take the lead on investments of this scale. But the 2005 RAND study found that there are important market failures -- bad payment incentives, lack of common standards -- that impede private investment and cry out for public answers. Allina's award could set the stage for an ambitious series of experiments in payment reform, quality control and interactivity that would put Minnesota at the forefront of a necessary revolution.

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