Electronic medical records: Why can’t NM get started?

By Sen. Dede Feldman

As anyone who has ever had a major illness knows, medical records can be a matter of life or death. An illegible prescription or a missing piece of paper about a previous illness can lead to the wrong treatment, a disastrous delay or unnecessary side effects.

That’s why policymakers at both the feral and state levels are tuning their attention to health information technology as an important part of health care reform. Proponents of electronic medical records, like Newt Gingrich, see improved health information technology as a way to cut costs and improve the quality of medical care.

In recent years, the Bush administration has been offering grants to organizations making the electronic transition, and has begun using the Medicare program to create an interoperable system. Missouri is implementing CyberAccess, an electronic system for its Medicaid program, and Minnesota is requiring all hospitals and health-care providers to have an interoperable electronic health-records system in place by 2015.

New Mexico is way behind the curve. The New Mexico Health Policy Commission recently reported that only one third of health-care providers had implemented an electronic health-record system. This year, in the Legislature, the Richardson administration met with stiff resistance from the medical and insurance communities when it pushed two comprehensive bills to speed (but not mandate) the implementation of records. The end result: Both bills died in the state Senate.

Given the widely acknowledged benefits of electronic records (Europe introduced electronic records years ago), why is health information technology so controversial here?

For providers, the issue boils down to the cost and inconvenience of changing practices. Older, private practioners are the most doubtful that the benefits are worth the costs, although many submit claims electronically in order to speed payments from insurance companies. Most younger doctors, especially those in larger systems, have already gotten with the electronic program, and some say that the transition is inevitable — over time.

Patient-privacy advocates are concerned about breaches of security and health information falling into the wrong hands, whether it be those of marketers, employers or insurers. They say patients have a right to know who is using their records and for what purposes — something that might be more difficult with electronic transmissions.

Meanwhile, as proponents and opponents debate, consumers are taking matters into their own hands, going to Web sites run by Google and Microsoft to assemble their own personal medical records. These records are collected from participating providers, like Walgreens or Kaiser Permanente. And while this system raises even more privacy concerns, it may be the best alternative for those who want timely and accurate diagnosis and treatment.

In light of the ongoing debate over whether to pass any state legislation regarding electronic medical records, and what kind of protections for patients, providers and other stakeholders it should include, the Legislative Health and Human Services Committee is holding an afternoon of hearings on the subject of health information technology today in Room 9010 at San Juan College, 4601 College Boulevard in Farmington. A number of providers and privacy experts will testify. Public comment is always welcome at the end of the day.

Feldman is a Democratic state senator from Albuquerque and chairs the Health and Human Services Committee.