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Apr. 2009, Washington Post: Digital Medicine

A Dose of Digital Medicine

Sunday, April 12, 2009; C06

In 2007, I walked out of my hotel in Brussels to get some dinner. The following afternoon, I woke up at Brussels University Hospital with a tube down my throat and metal "external fixaters" sticking out of my right leg.

I'd been knocked out cold by a hit-and-run driver. The Brussels ambulance service had scraped me off the pavement, just as the College Park Volunteer Fire Department would have done in my hometown. Those emergency workers saved my life.

Several days later, as I was preparing to fly to the University of Maryland Medical Center (where they would remove the "fixaters," replacing them with a metal rod), my Brussels doctor stopped by my room to give me a computer disk to take to Maryland. It held my X-rays and test results. My doctors, she told me, could use the information to avoid needless, expensive repetition.

I left Brussels with my disk of medical records and presented it to the team at UMMC. They were pleasantly surprised and made use of the information. When I asked whether Maryland would have given me such a disk had I been traveling the other way across the Atlantic, they said no.

Why is Maryland so far behind Belgium in harnessing the medical benefits of modern technology? The answer: A gridlock of special interests.

Unlike European countries, which over the last decade have moved to require doctors and hospitals to use basic information technology tools that would be familiar to anyone with an ATM card, the United States has waited for the "market" to carry its health system into the digital age. But instead of the "market" working to bring us into the 21st century, special interests have pointed fingers; argued that their system is better than any other; claimed that somebody else should pay for it; and blocked action. So today, hard as it is to believe, less than 20 percent of Maryland doctors' offices use electronic health records and less than half of hospital records in the state are digitized.

To break the logjam, Del. Joseline Peña-Melnyk (D-Prince George's) and I have introduced a bill for Maryland to lead the United States in meeting President Obama's goal of the digitization of medical records within five years. The bill includes five key elements:

-- Set detailed goals by sector (doctors, hospitals, etc.) and give the state Health Department the responsibility and authority to meet them by 2014.

-- Increase the reimbursements paid by insurance companies to medical providers to help pay the upfront costs of digitization.

-- Decrease these reimbursements after five years to providers who do not digitize.

-- Maximize the use of the hundreds of millions of dollars that Obama's economic stimulus package provides to Maryland.

-- And protect patient privacy with rules assuring that each of us owns our own medical records.

The Congressional Budget Office estimates that digitization by doctors and hospitals paid by Medicare could save $34 billion over 10 years. Belgium took this kind of step years ago. It's time for Maryland to catch up.

The writer is Senate chair of the Maryland General Assembly's Joint Technology Oversight Committee.