The Next L.A. / Reinventing Our Future : Health Care : IDEA FILE: The Ultimate Paperless Medical System

How it works: Anyone who receives any type of medical care has a computer file. Every hospital room, doctors’ office and medical emergency vehicle would be equipped with computers that tie into this central regional medical database. Paper charts become a thing of the past.

Benefits: Paper charts often get lost or destroyed. Sometimes care is fragmented because one doctor doesn’t know what another has done. Paramedics who treat patients in emergencies may have no idea of their medical histories.

Short-term or Long-term Impact?: Could be implemented in stages. Short-term implementation could done on a small scale within existing health networks. A regional or even national database would be long-term.

Supporters: They say it might save lives and improve health of the public by giving paramedics and doctors quick access to patient histories. Would save money and reduce the risk to patients of duplicative diagnostic procedures such as X-rays. Would streamline care and make the medical system more efficient, particularly in huge public systems such as Los Angeles County’s. Would eliminate need for storage space. A paperless system is incorporated into the design of the proposed Los Angeles County-USC Medical Center, scheduled to open in 2003. The design calls for computers in every patient room.

Opponents: Twinges of Big Brother--would open up possibilities for violating patients’ privacy. A field day for computer hackers--unauthorized users might be able to gain access to the database. Implementing the system is an enormous bureaucratic hassle. For example, Los Angeles County has already tried computerizing billing records in a first step toward a paperless system, but the $64.7 million system is in a state of near collapse due to bugs in the software and poor management.

The Costs: For a regional system, the best estimates to launch a system range into the hundreds of millions. But long-term savings could defray start-up costs. The costs to consumers and taxpayers would depend on the type of system implemented.

REALITY CHECK: Possible.