The Healthcare Database in the Clouds
Most countries, including the U.S., lack integrated online patient-record systems. Patients visiting new doctors' offices need to fill out paper medical-history forms. Over time, these records can become incomplete and difficult to access. This leads to both inefficiencies in the medical-record system, which costs money, and medical mistakes, which can cost lives.
Researchers and entrepreneurs hope to change that by giving each patient a smart card containing his or her complete medical history. This approach may prove difficult to implement in the U.S., as security fears and compatibility issues exist. However, the technology has the potential to transform healthcare in countries that have unified health systems, or where there's inadequate infrastructure for sharing records in other ways.
Currently, there is much debate surrounding medical smart cards. It is believed that no matter how flexible the software on the card becomes, it will not be able to automatically work with every hospital database. This is because healthcare providers will still need to cooperate to ensure compatibility. Opponents of the card-based system have deemed it "not a good fit" for the U.S. (per John Halamka, chairman of the Healthcare Information Technology Standards Panel and CIO of both Harvard Medical School and Beth Israel Deaconess Medical Center, in Boston). "We tend to be more network- and mobile-centric," he says, and "carrying around a card, which is common in Europe, is not our culture."
He is, however, more optimistic about the am alternative to card-based electronic medical records: the cloud. The U.S. needs "web-based personal health records in the cloud, available anywhere at any time without a card," he said. Such a network-based alternative may require greater changes to existing health-care networks, but it is likely to give physicians even better access to important patient information.
In addition, efforts to achieve an electronic medical-record system in the U.S., whether card- or cloud-based, are complicated by the fact that hospitals essentially compete with one another for patients. So sharing healthcare information while encouraged by the government may not be seen as an incentive for individual providers or hospital.
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