Dear EMR: Greetings from Paris, Wish You Were Here

Gienna Shaw, April 26, 2011

"Of course you fell down the stairs and sprained your ankle in Paris," my cousin said to me when I got back from vacation. "It makes for a good story." She knows that I love to tell stories—and experiencing France's healthcare system firsthand certainly makes for a good one.

At the time of my visit to the emergency room at the 987-bed Hôpital Bichat-Claude Bernard, I was slightly too distracted to reflect on how much better my care would be if the doctors could access my electronic medical records. Or print out documents in multiple languages. Or send digital X-rays and a report of the ED visit to my doctor in the U.S.—or at least hand them to me on a CD.  

But in retrospect, I'm sure of it.

No one in the emergency room at Hôpital Bichat-Claude Bernard spoke more than broken English, including my doctor. Other than a dismissive wave of his hand, he couldn't communicate the severity of my injury. He wrote a prescription that I couldn't read. I was given no discharge instructions. Just about the only person I understood clearly was the woman who pushed me in a wheelchair to the emergency room exit at the end of my visit and said: "Taxi?"

Most alarming, however, was that the only information collected from me was my name, address, and passport number. The hospital didn't ask for the name of my primary care physician. It didn't ask for my medical history. It didn't ask me if I was taking any medications. It didn't ask me if I have any allergies.

And it certainly never asked for a quick peek at my electronic health records.

I should say that the public health system in France has a good reputation for quality. And they are slowly moving toward adopting PACs. Based on the quick turnaround time I assume the imaging equipment they used was digital (the radiologist didn't know the word "digital," and I didn't know how to describe it in French). But still I had to carry x-rays on film home to my doctor.

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