Onions on pizza or blood pressure control?

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By The Staff

"Hello, Supreme Pizza, Carmen speaking, how can I help you Dr. Applebaum?"

How do you know my name?

"Caller ID, my friend, would you like the usual, vegetarian with extra onions delivered to 23 High Side Lane?"

That would be great.

"Ok, Dr., it will be there in 20 minutes and we'll charge it to your credit card on file, OK?"

Sure, thank you, goodbye.

Every day we interact with sales or service organizations that have an enormous amount of information about us in their computers. They use this information to provide accurate, efficient and timely service. We've come to expect this and get frustrated when we deal with companies who are "still in the stone age" - sound like your doctor, perhaps?

Most physicians have computer systems to manage the billing for their practices, but less than 10 percent of America's primary care physicians use computers to manage their patients' medical information.

Several studies have measured the percent of patients who get appropriate care for common medical problems. Results vary, but are mostly in the 50-70 percent range (i.e. blood pressure control).

Imagine if you got the right pizza on 60 percent of your orders, or FedEx delivered 30 percent of their packages to the wrong home, or if your bank's ATM only gave you cash 50 percent of the time.

Obviously, these companies would be out of business in short order. All of these industries are motivated to satisfy their customers.

Our health care industry, in contrast, is paid to take care of sick people, not keep people healthy. For the most part, the "medical industrial complex" is more profitable when more people are sick, not healthy. Hence in America, we have Sick Care, not Health Care.

We would all appreciate not having to go over our entire medical history every time we meet another provider. We would also feel a lot safer if we knew that any emergency department could retrieve information about the medications we take, the allergies we have, and the tests we've recently endured. This would save huge sums of money and minimize redundant, uncomfortable and potentially dangerous procedures.

So how can we get American medicine on par with the trucking industry and pizza parlors? If we wait for major health care system reform we will continue to cut down thousands of trees creating millions of incomplete, inaccurate, eligible un-searchable medical records.

Rather, we should trust that a national system of comprehensive medical records will lead to improved outcomes and decreased costs. While the political landscape for health care system reform is a minefield, who can argue against improved information at your doctors fingertips?

Clearly the country that put a man on the moon in eight years and won a World War in five is capable of building a database to manage all of its citizens' medical information in a safe, secure, privacy insured system.

The federal government could stage several competitive design and management competitions and develop a plan in less than two years. It could be implemented in less than another two. The only thing needed to digitize and thereby revolutionize American health care is leadership.

So next time your Congressman asks your opinion on health care reform or a politician asks you for a contribution, ask them if they will help you control your blood pressure or just promise you onions on your pizza.

- Gary Applebaum, M.D., is a senior fellow at the Center for Medicine in the Public Interest. He is the former executive vice president and chief medical officer of Erickson Retirement Communities.