Reform may propel digital records

Cost advantages in the use of digital medical records are a focusof President Clinton's health-care task force. Federal leadershipcould provide the impetus for cutting ties to medical hard copy.Until electronic records are accepted fully and legal questionscleared up, redundant medical archiving systems using both paperand electronic records will be a fact of life, according to RichardHaddock, president of LaserCard Systems.

Based in Mountain View, CA, LaserCard is a wholly owned subsidiaryof Drexler Technology. The firm produces the LaserCard opticalmemory card, which is a credit-card-sized multimedia archivingdevice holding 6.6 megabytes of medical records, including digitizedimages. Both physicians and patients keep copies of the archivalcard, which can be accessed with an optical card reader--manufacturedby Nippon Conlux of Japan--tied to a PC.

The archiving device can assist physicians in their practicesand reduce health-care costs, Haddock said. Although redundanthard-copy files are often maintained by health-care providers,they use electronic records for primary access to a patient'sfiles because of faster data recall and--in the case of the LaserCard--greateraccessibility and portability.

Hard-copy records might be kept in the hospital basement, requiringa costly search each time they are needed. Using a parallel setof electronic records, the health-care provider may pull up fileseven when responding to minor patient problems, he said.

LaserCard Systems continues to invest in user education, Haddocksaid. Customers are evaluating and familiarizing themselves withthe concept. There are reasons to believe, however, that changesin the U.S. health-care system will strengthen arguments in favorof digital record-keeping and the LaserCard, he said.

Over the past 20 years, computer technology in health carehas been used mostly to handle financial data, such as patientbilling. Recently, however, as interest in cost containment hasescalated, the focus has shifted to improving clinical procedures,he said.

"The obvious way to save money is to reduce redundanttesting and assure yourself that you are doing the proper jobin the first place. They can't do that without access to patientinformation. When that exists only in one place--buried in thebasement--it is impossible," Haddock said.

One stated goal of the national health-care initiative is todevelop an overriding federal law establishing the legality ofelectronic records, Haddock said.

Presently, each state has different legal requirements regardingthe maintenance of paper or electronic medical records. Thereis little chance that the states will modify their laws to implementa uniform health-care standard for digital records without federalintervention, he said.

"Without that (federal) law, you have 50 different stateswith 50 different laws about how to treat your own documents,"Haddock said.

LaserCard Systems markets its product through about 80 value-addedresellers (VARs) worldwide. VARs write application software andimplement particular archiving systems. LaserCard functions primarilyas a manufacturer of the card and basic systems integrator.

Novus Technologies of San Diego ordered 20,000 cards lastmonth. The firm sells an optical-card-based system for storingCT and MRI images.