Thursday, June 14, 2001

Dr. Dan Heslinga displayed the AboutMyHealth Web site
he uses to communicate with his patients on June 6 at Castle
Professional Center in Kaneohe. The site also allows patients
to request appointments and renew prescriptions.

Doctor pushes for
electronic medical records

The system used by Dan
Heslinga gives patients easier
access to their health records

By Helen Altonn

After getting a master's degree in physics, Dan Heslinga said he took a hard look at job prospects and switched to medicine.

Now, he is applying his technical interests to benefit patients in his family practice.

The Kaneohe doctor, in the Castle Professional Center, is one of a few doctors using electronic medical records and making them accessible to patients.

"It's just convenient for patients to get in touch with care providers," said Randy Brown, one of Heslinga's first patients to take advantage of the service. Heslinga said he was shocked to find "everything was done on paper" when he began his medical career.

Most hospitals have electronic accounting services but still have paper chartings, and fewer than 1 percent of doctors are computerized, he said.

"It's catching on. We're seeing more niche players in the last two years," he said, noting a prescription-writing computer program promoted by the Hawaii Medical Service Association.

The move toward integrated health-care delivery systems five to six years ago nudged hospitals toward electronic records to keep track of everything, he said.

"Still, there was less than 1 percent penetration in doctor's offices," he said. "I wanted to do it from the moment I finished my residency (in 1987 at the University of Iowa)."

He worked 10 years in Castle Medical Center's emergency room, then entered private practice, driven partly by his desire to computerize. He shared offices with another doctor until March last year.

Heslinga began using the electronic medical record system Logician in September 1998. Logician added AboutMyHealth (at to provide no-cost Internet service for medical records, and Heslinga teamed up with Medscape about a month ago to offer it to his patients.

He sent letters announcing "a pioneering service that will enhance the way we communicate." He explained that AboutMyHealth "is a secure private network for communicating with your doctor's office."

Heslinga said "it takes a fair amount of promotion," and he does not expect a deluge of patients wanting to see their records on computer. About 10 have registered so far, he said.

"More young than old, that's for sure," he added.

Both Brown, 48, and his wife are Heslinga's patients, but he is the only one using AboutMyHealth.

"I tried it and I like it," Brown said. "It's for my convenience, really. I can refill prescriptions, make appointments and confirm things. Sometimes he has instructions and I need clarification."

Patients can ask questions electronically and request appointments and prescription renewals. They can also log onto CBS Health Watch for general health information.

A recent Castle Hospital survey found patients want more information and more participation in decisions affecting their health, Heslinga said, and giving patients access to their medical information "makes sense to solve the problem of 'islands of information'" scattered in different places.

Working nights in the emergency room, he said, he would call for a chart that could not be found. "You can check your bank balance in Munich, but you can't find a record down the hall," he said.

If he asked a doctor if a patient had a living will, the doctor might say, 'I don't know; it's in the office," he said.

"The problem is, the information exists but it's not accessible," Heslinga said. "I'm enthusiastic about giving patients such access to bridge the gap between the islands of information."

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