Doctors, hospitals advised to keep records electronically.

• Author: Swartz, Nikki
• Position: Up front: news, trends & analysis

According to the Washington Post, about 10 percent of physicians' offices, and even fewer hospitals, now use electronic medical records exclusively. But a recent report suggests this is not good enough.

In "Patient Safety: A New Standard of Care" the Institute of Medicine called for hospitals and doctors to adopt electronic recordkeeping systems that would prevent tens of thousands of fatal medical errors annually and form the foundation for a nationwide exchange of patient information among practitioners and medical facilities.

The U.S. government would set standards for electronic records and error-surveillance systems but would not tell hospitals and clinics what systems to buy. Use of such systems, which can guide treatment decisions as well as catch mistakes, would be voluntary, said the institute, which advises the federal government on medical policy. The institute recommended, however, that electronic recordkeeping and participation in a national information network should become conditions for participating in programs such as Medicare, thus making them essentially mandatory.

The health information infrastructure envisioned by the authors of the report would give the U.S. government an unprecedented role in day-to-day medical practice.

The government would set the technical standards for information exchange, define medical errors, and tell hospitals what information to collect. It also would help specify what decision support functions computer systems should offer to physicians as they order tests, diagnose illnesses, and devise treatments. The government would oversee the "root-cause analysis" of errors and near misses and disseminate information about fixes and lessons.

The system would also create a much larger and more seamless network for disease surveillance. For example, it could allow a...