Will electronic health records ever arrive?

My family doctor provides excellent care, but he still works on sheets of paper in a manilla folder. An alternative, putting all this into a computer, is slowly creeping into medical practices.

I've seen an eye surgeon who uses such a system -- in fact, was learning the system with his staff when I was there. It can take longer to input data using the system, because it's pretty rigid about what goes where.

Ideally, such a system should bring in all kinds of information for the doctor's use, such as an updated recommendation from the Centers for Disease control on vaccinations.

Kenny Lin, a family doctor, writes in U.S. News that electronic systems have advantages.

An electronic medical record system can do that and can also allow test results to be emailed or transferred automatically into a patient's chart; paper charts rely on office administrators to input them by hand, which can lead to mistakes. I, myself, have occasionally forgotten to record that a vaccine was administered during the chaos of a busy work day. Nor did I have any systematic way of knowing how many of my patients were actually receiving the preventive and chronic care they needed.

However to truly be effective these systems need certain features, he writes.

The latest research suggests that electronic health records don't necessarily improve care unless they include interactive features: They should make it easier for doctors to implement proven guidelines for good care, providing the necessary shots and screenings, follow-up exams and treatments to help patients live longer with chronic diseases or to prevent these diseases altogether. Ideally, these records should include a software tool that periodically culls through patients' records looking for gaps in care such as who is overdue for a cholesterol screening or flu vaccine. The system would then send out reminders to patients to come in for a test or appointment.

One big outfit has such a system.

Kaiser Permanente added such a tool to their electronic medical record system several years ago and found that it works to improve care. A study published last month in the American Journal of Managed Care found that the support tool brought more diabetes and heart disease patients in for health screenings, vaccinations and medication adjustments. After three years, for patients with diabetes, the percentage of care recommendations met every month increased from 68 percent to 73 percent; for heart disease patients, the percentage rose from 64 percent to 71 percent. Another study found that tool helped more healthy patients get the recommended screening and exams for preventive care. Bottom line: This support tool lowers the rate of skipped appointments and gaps in care.

Change comes slowly. It's costly for doctors to implement a new system, and there are privacy concerns galore. However, I believe that anything that can be digitized eventually will be.