Microsoft Jumps on the Health IT Bandwagon

Microsoft launched a public relations offensive today as part of the unveiling of its new online health records service, HealthVault. Bill Gates, never one to shy away from a business opportunity, offered the conventional wisdom on the Wall Street Journal's editorial page:

By giving us comprehensive access to our personal medical information, digital technology can make us all agents for change, capable of pushing for the one thing that we all really care about: a medical system that focuses on our lifelong health and prioritizes prevention as much as it does treatment.

But as he pointed out earlier in the piece, "Already, nearly all procedures, test results and prescriptions are recorded in digital form -- that's how health-care providers transmit information to health insurers so they can be paid for their work. But patients never see this data, and doctors are unable to share it." Ditto for Medicare, the biggest insurer of them.

So, then, isn't it a simple task to insist that these electronic medical records be made available upon request to patients and other physicians (with patient approval)? Isn't it a simple task to pass a law that requires all physicians, hospitals and clinics transition to patient-available electronic medical records with portability if they wish to continue collecting fees from Medicare, Medicaid and other government programs, which account for nearly half of all direct health care expenditures?

There would be a front end cost to the transition, of course. But in a country that spends over $6,000 per capita on health, is it unreasonable to budget, say, $100 a record for switching to electronic records? In a country with 300 million people, that's $30 billion. Spread it over five years and the cost is barely noticeable, and significantly below what health insurance companies make in profit every year.

There are interoperability and data reporting standards that have to be resolved. But instead of having every potential vendor reinvent its own wheel, a logical way to proceed would be to universalize the system created by the Veterans Administration, which blazed the trail in electronic recordkeeping.

Strict privacy policies with powerful sanctions for violators must be enacted and enforced. Extra help for making the transition may have to be offered to solo practitioners or health services offered in poor areas. But the surest way to get to universal electronic medical records is to pass a law requiring it. If the nation waits for competing marketplace forces to solve this problem, it will lag behind standards that are already in place in Europe for another generation.