When the pain drug Vioxx was pulled from the market in September of 2004 because of concerns about heart and stroke risks, every Cleveland Clinic patient taking the drug got an e-mail within an hour of the recall. So did their doctors. At a Memphis, Tennessee, hospital, a red-alert system sends up warnings when medical professionals note the earliest, easy-to-overlook signs of sepsis, a potentially deadly response to infection. And in Massachusetts, a third of the doctors in one survey said they'd rewritten prescriptions to avert dangerous drug interactions.

Behind all of these quick saves: Electronic medical records. The YOU Docs love them. But whether you love'em or hate'em, we're all debating the upsides and downsides of EMRs -- as we physicians call them -- in the boardroom and around the kitchen table and the water cooler. It's a headline grabber: In the United States, $20 billion in taxpayer money has been set aside in President Obama's economic stimulus package to create a national medical-record database over the next few years, and in Canada, government health officials are pushing to increase the number of doctors using EMRs. These computerized replacements for scads of paper files could -- if you believe proponents like us -- help you live healthier and longer while you save money (no more repeat tests because your new doc doesn't know what the guy across town did, for example) and get more convenient care.

Downsides? The biggest concerns are two you've probably already thought of:

• Privacy. Even the Institute of Medicine is worried about this one, and last year sternly recommended that the government step up its game when it comes to protecting patient records from prying eyes. Many hospital systems audit who's looking at records -- and they will fire employees caught snooping. But if a national system is created, we'll need stronger safeguards.


• Medical identity theft. Hard to imagine anyone would want your tennis elbow or kidney stones, but medical identity thieves are after something far more valuable: Your health insurance benefits. An estimated 249,000 people have been the victims of medical ID theft, and it's tougher to fix than credit theft.



We think these are compelling reasons for a well-constructed security system, not for abandoning the idea of EMRs. Take a look at why we think going digital is still a great idea:

• Hospital stays get healthier. In a study of more than 167,000 patients in 41 Texas hospitals, researchers found that every 10% increase in the use of EMRs by a hospital reduced complications for conditions like heart attacks, bypass surgery, and pneumonia by 9% to 55% -- and decreased death rates by 15%. On a national scale, this could translate into 100,000 fewer hospital deaths per year.


• Drug interactions get caught before they happen. The more drugs you take, the more likely an interaction is; they kill more than 100,000 people per year in the United States alone. EMRs track what you're taking and flash a warning if your doctor prescribes something that would cause trouble. In one survey of 184 doctors who use EMRs in Massachusetts, 83% said they prevented medical errors, and 35% said the EMRs had prompted them to change a prescription within the previous month.


• Test results can be downloaded from home. No more waiting for the doc to call you back in the morning. Some hospitals with EMRs, like the Cleveland Clinic, let patients access test results directly, as soon as they're available. Patients in the Kaiser Permanente health network, for example, checked more than 16 million lab tests online last year. Not a bad idea to always check the results yourself. At one Veterans Administration hospital, nearly 20% of electronic "alerts"for abnormal CT scans and other imaging tests were ignored by doctors for 2 weeks -- even though they kept popping up on computer screens.


• Access can be had from anywhere. If you get hurt while bungee jumping at a resort thousands of miles from home, will the ER doc know about your drug allergies? With electronic records, your file is just a few keystrokes away.