It pays for UK MDs to use computers
CMAJ 1998;158:1595
© 1998 Canadian Medical Association
The United Kingdom is taking a practical approach to computer use among physicians — it is helping them to pay for the machines. Physicians attending the recent Fifth Annual Electronic Health Record Symposium in Toronto, which dealt with electronic health records and the Internet, learned that this is one of the main reasons why computer use is booming among doctors in the UK.
Dr. Ilias Iakovidis, a scientific officer with the European Commission Health Telematics Program (www.ehto.be), reported that 90% of GPs in the UK use computers in their practices and the high rate has been achieved because of incentives that reimburse physicians for 50% of the purchase price and 100% of training costs. As well, more than 60% of physicians in Denmark, Sweden and Holland use computers in their practices.
The Web's impact on health care was illustrated by Denis Morice, president and CEO of the Canadian Arthritis Society, who noted that the society's Web site (www.arthritis.ca) receives more than 12 000 hits a day and 40% of them originate outside Canada. The site has more than 14 000 pages available for physicians, researchers, other health professionals and patients, and is maintained by 170 professional and lay volunteers from across the country.
Meanwhile, Dr. Bill Haver, a Saskatoon family physician, said primary care physicians' "commitment to comprehensive and continuous care" gives them a direct interest in the relationship between electronic health records (EHRs) and the Internet. He said EHRs offer many advantages, including improved time management, access to a wider range of information sources and real-time consultation/sharing. However, he said governments, hospitals, regional boards, the CMA and others need to work harder to encourage doctors to use computers more.
The symposium was sponsored by COACH, Canada's Health Informatics Association, and cosponsored by the Canadian Health Record Association and the Canadian Institute for Health Information. It concluded with a debate on whether the Internet is a safe place for the communication of patient information. The pro forces argued that increasing numbers of consumers are showing confidence in the Internet by using it for shopping and personal banking. They reasoned that sensitive databanks could be protected if appropriate security measures are introduced.
The con team countered that users will have many responsibilities, including protecting the confidentiality of information and monitoring the system's integrity. An intranet, through which information is exchanged within organizations such as hospitals, encounters problems that include the sharing of passwords, a lack of respect for organizational policies and ethical considerations. Questions were also raised about who will be held accountable when problems arise and who should pay to ensure that high levels of security are maintained.
The debate's outcome was nebulous, since it raised more questions than it answered. Both sides agreed that the Internet offers many advantages, but the related hazards also need to be addressed.—Kevin Doucette, senior research analyst, CMA
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