Canada's health-care system wastes $7 billion every year on diagnostic tests that aren't needed and prescriptions that don't help. The reason is infuriatingly simple: Patient records, for the most part, are stored with technology that is dysfunctional.
Only one in three family physicians in Canada keeps computerized records. Most still use paper files.
When a patient is admitted to a hospital, sees a specialist, moves to another city or travels abroad, it's often impossible to lay hands on those records in a timely manner. In an emergency, it may not be possible at all.
An example: You step on a nail while in the garden. The puncture looks nasty, so you head for the nearest clinic because your GP's office is closed. The physician asks when you were last immunized against tetanus.
Do you remember? Because if you don't, you'll be getting a shot whether you need it or not. A paper record, at a distant location, isn't accessible.
Even when medical records are computerized, there is no guarantee they can be widely read. Patients often have files at numerous sites, such as medical laboratories, diagnostic clinics, hospital ERs and various specialty services. Theoretically these records are supposed to be linked, meaning any caregiver can see them all. But often that doesn't happen.
And the reason here is just as infuriating. There are numerous electronic filing systems, and most are incompatible with each other.
A similar situation once existed in rail travel. In the 1880s, rail lines reached across most of North America. But there were 20 different track widths, meaning longdistance passengers were continually stranded. That's where our health records are at - the 1880s.
So what can be done? Provincial health ministries have spent billions trying to link medical records. The federal government established a dedicated agency, the Canada Health Infoway, to move things forward.
Yet while there has been progress, a complete solution is years away, and more likely decades. Only four per cent of Canadians say they have access to an electronic health record.
At this rate, half of all Canadians alive today will be dead before the problem is mastered. And some of them will die because of it.
The cost of failure isn't just financial. The war against genetically based ailments such as cancer is moving from blunt instruments like chemotherapy to personalized therapies built on the DNA imprint of each patient.
But these treatments are very data-intensive. They cannot be managed with paper files or computer programs that won't talk to each other.
An age-old saying comes to mind: If you want something done right, do it yourself. The government of Alberta is working with communications giant Telus to create an electronic health vault. The idea is to let people create their own personal medical record.
The "vault" is basically a secure site where files can be stored. Patients can download personal material, such as immunization history, family medical records and readouts from home monitoring devices.
They can also ask health-care facilities they've visited to deposit diagnostic records, along with any medications that were prescribed.
The benefit is obvious. Whenever treatment is required, all of the relevant information is immediately available. And access is strictly controlled. No one can see the file without the patient's direct permission.
There are obviously significant challenges with such a system. The burden of record-keeping may be more than some patients can face. The content of medical records will sometimes be disturbing.
And security is clearly important. The project is promising bank-level firewalls to protect clients.
But here, at least, is one way that Canadians can maintain a usable record of their medical history. All we can say is, it's too bad we have to do this ourselves.
