Thanks to warnings embedded in the electronic health record, or EHR, Saver can monitor his patients' prescriptions to avoid harmful interactions. In case of a recall, he can check the database in minutes to find out whom to notify.
Elsewhere, there are even more promising signs.
Childrens Hospital Los Angeles, which installed an electronic record system five years ago, has all but eliminated errors in prescriptions, according to hospital officials.
In Hawaii, Kaiser Permanente reported a 26% drop in patient visits after the hospital giant implemented an electronic record system that allows doctors and patients to communicate more easily by telephone or e-mail for routine contacts.
And in New York, where the city has helped family practices install EHR systems, doctors are able to turn to their computers for guidance on recommended treatments.
The New York system, which links more than 800 providers, also allows public health officials to quickly tap patient data to track disease outbreaks and send doctors up-to-the-minute advisories.
"There are just huge opportunities here," said Farzad Mostashari, an assistant health commissioner in New York.
But those opportunities have proved difficult to realize for most American doctors.
A big barrier to wider adoption has been the upfront expense. Installing electronic record systems can cost more than $30,000 per physician.
Even when doctors buy a system, they can't be sure it will be compatible with other providers' systems.
If Saver sends a patient to the hospital down the street or a specialist across the parking lot, someone in the office has to fax or e-mail the file. When the patient comes back, records generated elsewhere must then be attached to the patient's electronic record back at Saver's office. Three people do virtually nothing else all day.
The federal stimulus package contains grants and financial incentives for those who use electronic records.
But the Obama administration faces difficult decisions about ensuring that the billions of dollars of federal money are not wasted on systems that don't work or cost too much. Also unresolved is access to patient data, an issue that raises questions about how researchers, pharmaceutical companies, insurers, even patients can use the electronic files.
By the end of the year, the Department of Health and Human Services is to develop a set of standards dictating not only what electronic health records should do, but who should control them and how.
All the while, government officials will have to navigate among a growing number of vendors maneuvering for a piece of the multibillion-dollar pot.
"We're kind of at the Oklahoma land rush," said Neal Patterson, founder and chief executive of Cerner, one of the country's leading health information technology companies.
Patterson and other established vendors contend that Washington must require EHRs to provide a full range of services. Others, warning of Soviet-style central planning, argue for fewer standards to allow quicker adoption of less expensive, if less comprehensive systems.
"The standards are good enough. The technology is good enough," Mostashari said. "We can't waste any more time."
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noam.levey@latimes.com
