Opinion

Want a cheap, practical and universal EMR system? Ask for MOM

LETTER — Posted Dec. 13, 2004

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Much emotionally charged opinion continues to fly around the issue of the electronic medical record (or for those who love to dabble in obfuscation and stir the pot by constantly redefining terms, the electronic health record, EHR).

May I boldly state that there is only one way that we will ever see a universal EHR that is nationally portable and readily available at physician office, emergency room/hospital, pharmacy and monetary payer sites.

That solution is to have a single national entity (a computer system IT department -- lets call it ITD -- at the highest level of the Dept. of Health and Human Services) develop and maintain a basic software-integrated system we shall call MOM -- the Manager of Medicine.

MOM must be free to all physicians, pharmacies, hospitals and payers. MOM must be nonproprietary property of the U.S. government and will operate on a range of hardware systems. MOM will use the Internet, or its successors, to provide connectivity. MOM will handle payment of all government health services, which will ensure the universality of its use in a very short time.

And most important, the responsibility for maintaining MOM's operational readiness will rest on the shoulders of ITD, i.e., the single government agent responsible for its development, updating and performance.

Software support companies will still be able to offer services if needed by end users operating with MOM's free basic software. If MOM is structured as a Web service, software support companies would be able to provide other users with user-specific features without alterations in MOM.

MOM will have the following advantages:

  • MOM will provide an efficient, fully integrated electronic medical information system.
  • It will be affordable, since it is free to all users. Cost for users will be small beyond computer hardware and Internet access.
  • Operational responsibility rests in a single, identifiable entity (ITD).
  • Government mandates will be fulfilled by an agency of the government, not by the end user.

If you think such a solution won't work, let me assure you it does work already on a smaller scale. The Dept. of Defense has an evolving MOM that connects military facilities across the USA (and beyond) and even reaches into civilian pharmacies already. It surely isn't perfect, but the concept works because the organization mandating MOM's structure and capabilities is the same organization which must accomplish the mandate.

So I ask Congress to mandate the future of electronic health care. Then Congress should take on the responsibility to build MOM to meet that mandate. Please call me when MOM is ready to be installed on my G9 Mac.

David W. Goetz, MD, Morgantown, W.Va.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/12/13/edlt1213.htm.

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