Saturday, May 10, 2008

Peak Oil and electronic health records

Dan Bednarz is continuing to do a lot of good work in the US spreading the word about peak oil and its relationship to health care. This piece is from a talk he gave to a group of nurses. In it he mentions that electronic healthcare records might not be possible in the future... obviously a US thing - electronic records are quite a way off all together here!

Given the need to reduce our energy use in the face of peak oil, and given that electronic records will only add marginal clinical benefit to patient care (the talk of clinicians knowing about your medical history through access to an electronic health care record is of great use in a small number of cases, but for many patients could detract from useful assessment and diagnostic thinking), do we really need to continue with them?

His main points are summarised below and the full article is available from The Oil Drum:


1. I feel safe observing that the vast majority of insurance companies, medical associations, HMOs and other hospital associations will resist facing the stark consequences of peak oil because they are benefiting from the status quo. On the other hand, those hospitals with a mission for stewardship of the earth and charitable activity are likely to be among the first to recognize the need for radical change in medical care.

2. In the same vein, it's obvious that nursing is not prospering even though it is in some ways the backbone of the system. Your profession's main themes for reforming the healthcare system should center-–I hate to use the word "should"--around radical resource conservation and efficiency, and the elimination of wasteful and environmentally harmful practices. In other words, reduce, reuse, recycle, and repair.

3. Simultaneously, there will be a political struggle for the soul of healthcare: We will look to other nations with decent health systems where three core values predominate: 1) no one goes bankrupt due to medical status; 2) no one is denied treatment for any reason, and 3) preventive and treatment medicine are integrated. This means one response to energy downturn leads to healthcare for all. The alternative to this is medicine becoming something for the wealthy few, with the rest of society receiving what amounts to triage-–or, alternatively, home care or "folk medicine." In some respects these alternatives represent the familiar themes of the Jeffersonian/egalitarian and Hamiltonian/elitist traditions.

4. By forming a coalition with public health and even some of the growing number of doctors who favor a "single-payer" system, nursing can shape the transformation of our healthcare system.

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