The New Health Dialogue

Denmark may have lost the title of "happiest place on earth" to Costa Rica, but it still has health IT.

The Danish have, according to several studies, the most efficient health information system in the world. All primary care physicians and almost half of the hospitals utilize electronic records, in comparison to just 10 percent of hospitals and 17 percent of physicians here. The Danish information system saves doctors about 50 minutes a day in administrative work, and a 2008 report from the Healthcare Information and Management Systems Society estimates that the electronic records system saves Denmark $120 million annually.

Ebben Harrell of TIME provides a nice summary of the savvy and centralized Danish system:

Denmark has a centralized computer database to which 98 percent of primary care physicians, all hospital physicians and all pharmacists now have access. Danish residents can gain access to their own records through a secure website. The website alerts the patient by email if a doctor, pharmacist or nurse views their records, and allows patients to make appointments, set end-of-life wishes, and even email their doctor for advice on illnesses that do not require an office visit. While basic records go back to 1977, a detailed history is available of all "patient contacts" since 2000.

Jens Danstrup, Sindya Bhanoo reports yesteday in the The New York Times, can essentially “visit” with his doctors at the Fredriksberg Hospital without ever have to leave the comfort of his home. He learned to use simple medical devices and has a web camera for video-conferencing. His weekly medical updates, sent to his doctor through a Bluetooth connection, are automatically added to his electronic health record. His prescriptions are paperless and can be accessed from any pharmacy in Denmark. To ask his doctor a question, all he has to do is write an email and click “send.”

And over at Thy-Mors Hospital, doctors have started to use I.B.M software to superimpose data from patients’ electronic health records onto three-dimensional images of a human body. The doctors are able to get a quick survey of the patient’s medical history and can rotate the image and click on specific “ailments” to zoom in and get more specific information. Moreover, ambulances can update patients’ electronic medical records from their vehicles, so doctors can be aware of the patient’s medical condition and history before the ambulance arrives at the hospital.

The Danish system isn’t perfect, and it certainly has had growing pains. Harrell explains that right now, there isn’t one “over-arching [record keeping] system” but “record keeping utilizes various compatible systems, linking networks established by regional health agencies.”

Still, Dr. John D. Hamalka, an adviser to the Obama administration on electronic health records, explains that Denmark gives the United States a “peek into the future, with some logistical variations.”

We’re also making progress in the United States. The Department of Veteran’s Affairs and the Kaiser Permanente health system, two of the country’s largest users of EHRs, announced last week that with patient authorization, EHRs will be able to be shared between the two systems.

America, with its 50 state governments, large size and “multiplicity” of privacy laws, reports the New York Times, probably will never adopt a national health registry like Denmark. But we can learn from them. And see how technology has benefited this small and technologically advanced country. Incorporating health information technology will be a gradual process, but, as Dr. Hamalka said, “The standards have been set for parties to communicate. There’s hope, and we’re on the right trajectory."