Letters to the Editor - Nov. 7, 2005

VA's system a solid model for how to create an electronic medical record - Get right software, not a drill, to properly destroy computer data

VA's system a solid model for how to create an electronic medical record

Regarding "The best future for EMRs would be single, national system" (Letters, Oct. 3): I agree with the letter by David R. Jackson, MD, of Florence, Mass., in favor of a national electronic medical record as the Dept. of Veterans Affairs system has.

I have seen the progress over the last several years in our Memphis VA with the implementation of the VistA Computerized Patient Record System. The VA system allows optimal fast access to patient records to improve patient care. The VA EMR has also facilitated my education during my training, in that I can look through medical records, diagnostic studies and images quickly when the information is at my fingertips. The VA has become my favorite training institution due to the ease of medical records, physician order entry and online imaging. (Learning happens faster when information is at your fingertips.) In addition, it is frustrating when patients are transferred from other hospitals with different EMRs that I can't access from the VA. Physicians of my generation who have trained in VAs have come to expect immediate access to patient information because of the EMRs in our academic centers.

Patient care is improved with the VA system. Americans cannot be expected to know intricate details of their medical histories or diagnostic procedures (caths, biopsies, etc). With the help of the VA EMR, I can provide better care for patients and learn more about their complex diseases. With the VA system, veterans are able to travel to other VAs in the country, and their medical information from their home VA is easily accessible by other physicians and caregivers.

I pray that when I am older with complicated medical issues, my medical information, ECGs, cath reports, path reports, discharge summaries, etc. will be at my physician's fingertips to help aid in decision-making for my care. Like the veterans, I hope one day that my medical information can travel with me across states too. It is a shame that I can't say the same for my parents' medical records with our country's current lack of a national EMR system. Should my father have an MI in the future, his ECGs, cath reports and CABG report will not be available to his doctors, should he be going to cattle auctions or visiting family in other states.

I pray that our country will adopt a standardized national EMR soon to improve access to patient records to aid in emergency decision-making that affects patients and families.

--Christiana M. Lietzke, MD, Memphis, Tenn.

Get right software, not a drill, to properly destroy computer data

Regarding "Going beyond delete: How to really erase information" (Article, Sept. 12): Your otherwise excellent article had one recommendation that was not correct, and it revolved around how to ensure that no data can be recovered from a hard drive.

The article states: "One way to ensure that data are permanently erased is to physically destroy the hard disk by removing it from the box and drilling a hole right through the center of the disc." This is not true.

If you simply drill a hole through the center of your hard drive, obviously it will not work in a conventional computer; however, data will remain on the platters, except for areas that were physically destroyed by the drill or its vibration. Should the drill go thru the center of the disc much of the data may remain. Companies that specialize in data recovery from physically damaged drives might be able to remove the individual discs in the hard drive without further damaging them and recover a considerable amount, and possibly all, of the data, depending on where the drill hole was made.

Using software such as programs conforming to U.S. Dept. of Defense standards for clearing and sanitizing sensitive information and degaussing the drive, which are other options you allude to, will give better insurance of data destruction.

--Brett Elliott, MD, Milford, Del.