Time Capsule: I’ll Alert the Media: Why Not Use Cheap, Easy Multimedia to Store Patient Information?

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in February 2008.

I’ll Alert the Media: Why Not Use Cheap, Easy Multimedia to Store Patient Information?
By Mr. HIStalk

Clinical systems vendors don’t seem to have noticed that it’s now easy and cheap to record and store photos, audio, and video on computers. Everybody’s snapping a digital photo, recording MP3 audio, or using a cheap camcorder, camera, or cell phone to make a video recording that, while not exactly “Lawrence of Arabia” quality, is plenty good for nearly every other purpose. Storage isn’t a problem, either, now that you can dash into Best Buy and leave with a terabyte of external disk under your arm for $229.99, according this week’s ad.

Maybe doctors haven’t noticed either. Otherwise, why wouldn’t they be retooling their practices to take advantage of cheap media? A picture is easily worth a thousand words, especially at today’s transcription rates. Doctors will peer endlessly and intently at diagnostic images and try to describe them in great detail with words, but are happy to read another doctor’s description of a wound or surgical procedure instead of demanding to see the actual photo or video of it.

Having something more than a mountainous chart (most likely paper, but possibly either electronic or an ugly hybrid of both) would sure be an advantage in trying to remember what the patient said two visits ago, what their infected eye really looked like, or what their exact words were in describing their chest pain.

Instead, doctors jot down a few illegible notes, taking time away from the patient to perform that secretarial work they complain bitterly about when it’s CPOE or e-prescribing.

Medical schools must be training them wrong. They’re documenting care and interventions like it was 1908. If this was Playboy, there would be no centerfold, just a wordy description to go along with the World Peace interview.

It would sure be nice to have the patient’s information captured in the EMR in something other than black letters on a white background. “Nice” is being too kind. It’s just ridiculous that our supposedly savvy move from paper to computer means only that the screen looks just like the paper.

I could rattle off hundreds of clinical benefits, but instead, I’ll play my most convincing trump card first and save us both the time: lawsuits.

Lawsuits are always “he said, she said.” The patient claims they weren’t warned, or the doctor says they weren’t told, or the surgeon swears he removed the sponge that somehow stayed inside the patient. Healthcare volumes are so high that no one remembers accurately, if they even remember at all.

That guy with the infected toe that the ED doc saw for 90 seconds comes back without the toe, but with a lawyer. There’s just no way for the doctor to look good trying to decipher a ratty pile of badly written paper in front of a puzzled jury and a mad-dog ambulance chaser.

Imagine if every exam room had a constantly running camera recording audio and video. Everything the patient says, everything they are told, every action that was performed – all recorded perfectly. At the patient’s next visit, it would take seconds to call up a fast-forward version, prepping the doc to impress the patient by noticing that her hair has been attractively cut or his wedding ring is now an untanned finger line.

If the lawyer is in tow (no pun intended), there is no gray area. Every scrap of information is right there in low-res video and audio, plenty good to stop most lawsuits cold (unless the doc is a quack, in which case the cameras and microphones should be avoided like the plague).

It’s as easy and cheap as having multiple security cameras in an office building or a Nanny-Cam. Privacy issues would need to be worked out, but those relating to technology and cost are done deals.

Today’s media can capture every nuance of physical fact, verbal cues, and the dynamics of a particular interaction, all permanently, cheaply, and easily retrievable. For that reason, it seems ideal for the practice of medicine, nursing, and other healthcare delivery, not to mention the educational and performance aspects. Maybe everybody’s just too busy to have noticed.