Ordinarily, a family doctor maintains an inventory of each patient's medical history.
But say the patient visits an outside specialist, or receives treatment at an emergency room. Without a complete record on hand, the attending physician has no baseline from which to refer, and thus may misunderstand the symptoms, order unnecessary tests — even make a medical error.
DbMotion, an Israeli-based company, has developed a potential antidote to this quagmire: virtual patient records.
Through the company's computer-software program — the dbMotion solution — physicians, pharmacists and other health-care providers can gain access to an online version of each patient's medical history, including previous lab tests, emergency treatment, specialized care and drug allergies.
And, rather than gleaning such data from a series of disparate faxes and files, physicians that log on to the system receive all the relevant clinical information on one screen — at a simple click of the mouse.
Since it was first developed in 2001 as a pilot project for a single health-care entity in Israel, dbMotion technology has grown into a network connecting some 16 hospitals and 1,300 clinics, and serving nearly 5 million citizens in the Israeli state.
With company representatives now marketing the product internationally, several U.S. health-care providers have begun to jump on board.
One of these is a regional cluster of providers in New York known as the Bronx RHIO, or Regional Health Information Organization. Another is the University of Pittsburgh Medical Center.
'Not Aware of It All'
Speaking at a networking event held by the local chapter of the America-Israel Chamber of Commerce in Center City, Joel Diamond, a Pittsburgh-based physician who acts as dbMotion's chief medical officer in North America, explained the need for such software, citing as the major reason that incomplete data can be lethal.
As evidence, he pointed to a report by the Institute of Medicine, which suggested that between 44,000 and 98,000 Americans die each year as a result of medical errors. The study, which was published in 2000, claimed that medication errors alone account for more than 7,000 deaths per year.
"The majority of those come from lack of information or incomplete information," stated Diamond. "Prescribing doctors are just not aware of it all."
In addition to providing an integrated data set, the solution offers some decision-support capabilities, he continued. For example, the software can help health authorities identify possible epidemics by focusing on patterns of similar diagnoses. It can offer assistance on the micro level, too, alerting physicians when a patient's allergy, for example, may prohibit him or her from taking a certain medication.
The technology can also aid efficiency, according to Diamond. As the physician explained, existing handwritten records, which may or may not be complete or out of date — or legible — may lead doctors to order repeat tests and procedures, both of which eat up time and money.
"One in five X-rays tests ordered in the U.S. were ordered because the originals could not be found," said the doctor. "Each one of those tests could costs thousands."
What's more, the software has come into play during times of crisis; for example, during Israel's war with Lebanon last summer.
"When Haifa was bombed, people went to stay in cities with relatives in Tel Aviv, and their medical records were available," noted Diamond. "Compare this to Hurricane Katrina, where the treatment and the drugs didn't go so smoothly."
Still, implementing the program stateside may not be easy.
According to Ilan Freedman, dbMotion's vice president of marketing, family physicians and practices in the United States have a lot of catching up to do; he said that only about 10 percent to 20 percent of them even use electronic records.
"Most clinics document with pen and paper," declared Freedman, speaking from company headquarters in Hod Hasharon. "The U.S. health-care system knows that it is inefficient in the way that it spends health-care dollars."
Freedman also noted that the U.S. market presents an issue of misaligned incentive. Because health-care providers do not foot medical bills in this country, the executive argued that in some cases, they have little reason to cut costs.
"The party that pays the bill is the insurance company," he said, "but it's the health-care provider that holds the key to solving the problem of lack of information at the point of care."
But with increasing attention being paid to the field of health informatics, Freedman said this trend may be starting to change.
In 2004, President Bush established a new position for a national coordinator for health-information technology. Like the political leadership, industry insiders are starting to sow investments:
A 2007 report by the Healthcare Informational Management Systems Society projected that hospital capital spending for I.T. applications is expected to increase by as much as 12 percent by 2011.
Freedman argued that over time, the U.S. system will only further realize that "if you look at the basic premise of what our technology does, it does something that makes sense for any health-care system anywhere."
Diamond agreed: "Care is so fragmented here. We don't have an air-traffic control center [for health care], and that's the infrastructure that we need."