Medicare patients in Indiana can test a new step toward computerized health care this fall by logging onto an Internet site and printing out all their recent medical tests and diagnoses.
It's one of a series of steps the federal government is announcing Wednesday to help move toward President Bush's goal of ensuring that most Americans have computerized medical records available within 10 years.
In addition to the Indiana Medicare pilot project, the government will fund $50 million in grants for community and state experiments in creating electronic health records and local computer networks linking doctors and hospitals.
"We're still using, in too many cases, manila folders and handwritten prescriptions and bags of records," Health and Human Services Secretary Tommy Thompson said Tuesday.
Computerizing medicine is "one of the most important things we can do to improve the quality of health and at the same time make the cost of health care more affordable," he said.
At a conference bringing together more than 1,500 information technology specialists and health leaders, Thompson will outline a plan to spur electronic health information by setting technology standards and providing financial incentives for doctors and hospitals to invest.
"As a field, health care is clearly lagging other industries," said Scott Wallace, president of the National Alliance for Health Information Technology. The new plan "does some pretty ambitious things to move the field forward."
Topping that list, Wallace said, is the Medicare Internet experiment, "something my mother could use."
Medicare already tracks recipients' health records by using billing codes. The new program will translate that information into "language you're going to be able to understand, and that's the beauty of it," Thompson said.
Indiana will be first to test the system, which eventually will add information about what preventive services each recipient might qualify for or need. If the pilot project works, Thompson hopes to quickly expand it nationwide, perhaps next year.
A true electronic health record would go further. For example, if someone is unconscious from a car crash 100 miles from home, the emergency room could link to his regular doctor's office to learn information that might be crucial to his care.
Indianapolis is among the furthest along in setting up such doctor networks, Thompson said, and will be one of the recipients of the new grants to try to spread those networks to cover entire regions and states.
Some doctors, hospitals and pharmacies already use electronic health records, such as paperless prescriptions and software that links a patient's medical history to guidelines on how his or her disease is best treated.
But electronic medicine still isn't widely used, and most of today's computerized medical records are hospital- or pharmacy-specific. Just 13 percent of hospitals and no more than 28 percent of physician practices had electronic health record systems in 2002, the latest data available, according to HHS.
Yet routine use of electronic records could help reduce the tens of thousands of deaths and injuries caused by medical mistakes every year, according to a recent analysis by the Institute of Medicine.
It's not that doctors prefer paper, stressed Dr. James Rohack, chairman of the American Medical Association's board. But there are serious challenges:
_Patients' privacy must be protected from computer hacking.
_Computer data must be backed up so a crash or a power outage doesn't block access to a record when the patient needs it _ or erase records altogether.
_Many doctors work in rural areas that don't have access to high-speed Internet lines that some of this technology requires.
_Many of the simplest computerized systems, like medical record dictation systems and electronic prescribing systems, don't mesh.
"We know to diagnose a brain tumor _ an MRI is better than a plain X-ray, so you invest in an MRI unit at $1.5 million-plus," Rohack said. "The black eye that says doctors don't want to deal with technology or hospitals don't want to invest _ I don't think that's a fair shot."
