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...America's medical records by 2014. Denmark has already made the transition. The country has a centralized computer database to which 98% of primary care physicians, all hospital physicians and all pharmacists now have access. While basic records go back to 1977, a detailed history is available of all "patient contacts" since 2000. A recent study by the Commonwealth Fund, a health-care-reform nonprofit, rated the country's health-care IT systems as the most efficient in the world, with computerized record-keeping saving Danish physicians an average 50 minutes a day of administrative work. "That's essential...
Denmark boasts several advantages that have helped in the early adoption of electronic health records. It is small (population: 5 million) with a tech-savvy citizenry and a public sector-run health system. Trust in the government is high. Most crucially, when the health service established a National Patient Registry in 1977 - a system that required doctors to file patient visit details in order to be reimbursed for their work - the country unknowingly laid the groundwork for electronic health records by putting in place centralized record-keeping...
...challenge is finding the funding to implement such schemes. In America's health system, there are few financial incentives for providers to take proactive measures to keep people healthy: the longer and more extensively a doctor or hospital treats a patient, the more income they recoup. That's why the American College of Physicians and others are calling for reform in health-care reimbursement, with the Federal Government and large insurance companies setting up "Patient Centered Medical Homes" in which a portion of doctors' pay will be linked to performance targets. As in Germany, these homes will target chronic diseases...
NICE uses a metric called "quality-adjusted life year," or Qaly, which grades a person's health-related quality of life from 0 to 1. Say a new drug for a previously untreatable condition comes on the market and the drug is proven to improve a patient's quality of life from .5 to .7 on the scale. A patient on the drug can expect to live an average of 15 years following the treatment. Taking the new drug thus earns patients the equivalent of three quality-adjusted life years (15 years multiplied by the .2 gain in quality...
Peter Pitts of the Center for Medicine in the Public Interest says higher prices are a risk America will have to take. "Because NICE is concerned about saving money and not what's in the best interest of the patient, its methods are not only imprudent, they are unethical," he says, arguing that pharmaceutical firms use profits to fund research and development. Rawlins has a different take. "All health-care systems have implicitly, if not explicitly, adopted some form of cost control. In the U.S. you do it by not providing health care to some people. That's a rather...