He's also done a lot of research on how to improve the quality of care by changing the way doctors run their offices and how they interact with patients. Things like how the way they give physical exams, the types of questions they ask patients, how much time they spend with each patient, rather than focusing strictly on things that ooze or scream when you poke them.
That's exactly the kind of process analysis that would show the benefits EHRs are supposed to deliver, but only if the analysis focused not on the person doing the poking, but the number of people, amount of work and amount of time required to get all the information in one place that would give the poker the timely information he or she needed to know where to poke and how hard.
Right now getting a diagnosis from a specialist could involve collations of data that would give a DBA headaches. Your bloodwork might come from the hospital's lab in the basement, which puts all its data on a server that may not be accessible to independent specialists like yours, who only rent space in the hospital and don't have to adhere to its IT standards.
Knowledge of your innards could come from an MRI clinic across the street that deafened you while magnetizing your gut and routes gigantic image files only through secure, high-bandwidth network connections for which the specialist has to pay extra.
Your main medical record has to come from your primary doc, couriered over in a file folder filled with paper and disks in incompatible file formats going back years. Without that record -- which includes those last two embarassing physicals and an explanation that the mass in your gut is a slow-healing lump from the time when you slipped a wheelbarrow poked its handle in your belly as revenge for having overloaded it in the first place -- the specialist might send you down for surgery, not out for ice cream on the way home.
So far, though, only half of U.S. hospitals have even qualified for the upgrade program, only 12 percent completed adoptions of ERH systems as of January, 2010, and fewer than 2 percent were doing enough with them to qualify for the TARP money.
Just getting the record together, let alone collecting and updating it within each office or dealing with insurers to pay for everything, is so huge a pain that allowing it to continue with a mix of paper and non-standard digital formats is criminally stupid and fiscally irresponsible.