Robot nurses

Denmark's use of medical technology, particularly technology that allows elderly patients to conduct tests at home and send the results to their doctors over the internet, is certainly intriguing and one of the more exciting possibilities of health care reform in this country. One of my biggest peeves is the need to fill out reams of data about myself every time I visit a different health care provider, and imagine if those who require health monitoring don't have to find a ride to the doctor or spend the day waiting in hospitals.

COPENHAGEN — Jens Danstrup, a 77-year-old retired architect, used to bike all around town. But years of smoking have weakened his lungs, and these days he finds it difficult to walk down his front steps and hail a taxi for a doctor’s appointment.

Now, however, he can go to the doctor without leaving home, using some simple medical devices and a notebook computer with a Web camera. He takes his own weekly medical readings, which are sent to his doctor via a Bluetooth connection and automatically logged into an electronic record.

“You see how easy it is for me?” Mr. Danstrup said, sitting at his desk while video chatting with his nurse at Frederiksberg University Hospital, a mile away. “Instead of wasting the day at the hospital?”

He clipped an electronic pulse reader to his finger. It logged his reading and sent it to his doctor. Mr. Danstrup can also look up his personal health record online. His prescriptions are paperless — his doctors enters them electronically, and any pharmacy in the country can pull them up. Any time he wants to get in touch with his primary care doctor, he sends an e-mail message.

All of this is possible because Mr. Danstrup lives in Denmark, a country that began embracing electronic health records and other health care information technology a decade ago. Today, virtually all primary care physicians and nearly half of the hospitals use electronic records, and officials are trying to encourage more “telemedicine” projects like the one started at Frederiksberg by Dr. Klaus Phanareth, a physician there.

Several studies, including one to be published later this month by the Commonwealth Fund, conclude that the Danish information system is the most efficient in the world, saving doctors an average of 50 minutes a day in administrative work. And a 2008 report from the Healthcare Information and Management Systems Society estimated that electronic record keeping saved Denmark’s health system as much as $120 million a year.

Now policy makers in the United States are studying Denmark’s system to see whether its successes can be replicated as part of the overhaul of the health system making its way through Congress. Dr. David Blumenthal, a professor of health care policy at Harvard Medical School who was named by President Obama as national coordinator of health information technology, has said the United States is “well behind” Denmark and its Scandinavian neighbors, Sweden and Norway, in the use of electronic health records.

Denmark’s success has much to do with the its small size, its homogeneous population and its regulated health care system — on all counts, very different from the United States. As in much of Europe, health care in Denmark is financed by taxes, and most services are free.

Privacy about medical records is certainly an issue. As an aside, it's interesting to note the different aspects of privacy concerns in the U.S. and Europe; here, we worry (in addition to financial information) about medical records more than just about anything; in Europe, things like political persuasion and union membership are considered highly sensitive, probably because health insurance isn't an issue, while civil and labor unrest often are.

But there seems to be a lot of other daunting things to overcome:

• Our level of access to broadband, relative to countries like Denmark, is pathetic
• Our education levels, particularly among a broad swath of older Americans, is likely hard to overcome

And those are the reasonable concerns. Add to that fears that "Obamacare" is about the government "taking over health care" and wants to compile data on you for nefarious purposes, and the possibility of electronic medical records seems like a far-off dream.