The Costa Rican Caja de Seguro Social was justifiably considered a whopping success in the years after its inception in 1948, and regarded as a proud achievement of the government: free health and medical care for everyone.

But over the years the pride has slowly faded away as the lines of persons needing medical attention have grown longer and longer, and even critical surgeries and other specialized procedures are frequently scheduled years into the future.

Anyone needing medical care, or even their monthly pharmaceutical prescriptions, can be sure of at least one thing: long lines, long waits, and being attended by harried medical personnel working among much disorganization.

But this is not a problem; it’s a symptom. In other words, in a wannabe medical system that must offer more and more specialized services to a growing population, but still using archaic methods of creating and maintaining medical records, this could be considered completely normal.

The thing most lacking in the country’s medical care system is an automated, comprehensive medical information system. Or if you will, electronic medical records to replace all papers, forms, and filing systems. This effort should have been started decades ago, before this problem has become so acute.

In such a system, data has to be only entered once, and that is facilitated by the use of light pens to click information presented on the computer screen. For example, to begin a new patient medical record, the patient’s name would be entered on the keyboard, but other information such as sex, type of problem, etc is typically entered using the light pen and clicking on the appropriate item. This has to be done only once; if the patient has already been entered into the system, the record is only updated.

The computer would then normally print out a patient identification bracelet, and as the patient passes through the various stages of diagnostics and treatment, his or her medical record would appear on the computer screen in each one of these medical stations. Click! Click! . . . Plus a few keyboard data entries and it’s all done.

Although, most persons are not aware of it, there are many errors made in a non-computerized hospital. Doctors are notorious for their illegible handwriting, and it is so easy to confuse a prescription for “.5 Mg” of something with “5 Mg”, which means the patient would receive 10 times the dosage prescribed by the physician, all because of an invisible dot. This doesn’t happen in a “smart” hospital because there is no paper and no writing. Moreover, if the physician were to accidentally click on “5Mg”, the computer would compare the prescription to what is normally prescribed, and the entry would be instantly flagged as questionable.

The second the physician enters the prescription, it is received in the pharmacy and the labels, including the patient ID number, are printed and the prescriptions filled. Patient scheduling is also greatly facilitated, with follow-up visit appointment times and dates automatically being generated, printed and also entered in the physician’s calendar.

A medical information system is also a medical data system, which opens the door to advanced medical research capabilities and administrative studies. For example, outbreaks of H2N5 influenza in a particular locale could be immediately spotted and the appropriate vaccines transported to that place before the epidemic even had a chance to develop. Professional Standard Review studies (PSRO) would greatly improve patient medical care and help physicians select the best treatment modality.

If such a system were implemented throughout all the Caja’s facilities nationwide, all patient information and history would be instantly available – but in a secure form – anywhere and at any time. Currently, this is a problem when, for example, someone from San José might need medical care in Puntarenas. Through the Internet, too, a physician could check on his hospitalized patients from his own private office or home.

But looking still farther into the future, the current trend in advanced countries is toward integrating medical information systems on an international level. Such a capability might give Costa Rica a definite advantage in offering medical tourism, which is a growing industry.

The advantages of having such a system are virtually endless, from vastly improved patient care and faster processing to administrative and efficiency studies to drastically cutting costs. Savings, greater efficiency and better patient care made possible through the implementation of such a medical information system would far outshadow its costs.