Elec. Medical Records: Are $$$ really the Obstacle???
Posted by steven_spear | Under Stimulus Package, health care, high velocity organizations Tuesday Apr 7, 2009Excerpt: The Obama administration proposes $10 billion/year for five years to encourage electronic medical record adoption. Can money be the main obstacle? The health care sector is $2.2 trillion, 1/2 of which is spent on hospital, clinic, and practices services. $10B is a drop in that bucket. The IT industry runs into the $100s of billions too. There must be some other obstacle for which money is not the solution. What do you think?
In an editorial the NY Times asserted that the main obstacle to electronic medical records is money (”Miles to Go on E-Health Records,” NY Times April 2, 2009).
How can that be?
Medical professionals, like other people, budget scarce resources considering cost and benefit. According to the Centers for Medicare and Medicaid, total health care spending in 2007 was $2.2 trillion, about half of which is for hospital, physician, and clinical care. The $10 billion/year proposed government subsidy for EMR would be less than 1% of either total, less than a penny on the dollar. Yet, as proportionally small as that is, these marvelous systems are not implemented. Why not?
In contrast, people freely spend approximately $30 billion/year with Apple, $60 billion/year with Microsoft, and more than $100 billion for IBM because they see value in those products.
Before we throw money at a problem, it behooves us to understand better why the problem exists and why it is not being addressed already by the people most affected.
If EMRs have such promise, why are they not freely adopted?
Any thoughts?
Please share them.
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People should take network effect into consideration. If only one hospital implments EMR, the benefit is not so obvious. However, if hospitals have to exchange data, the benefit of EMR implementation will be obvious. However, in traditional healthcare world, data exchange is not a big need.
Thank you for your comment. Your focus on network externalities seems logically sound. However, there are already these large integrated systems, large providers, large practices, and so forth. It would seem there is the internal scale to justify these investments. I’m wondering if there is something more.
The market is saturated with hundreds of EMR/EHR/PHR systems. Most of them are inefficient systems that disrupt physicians’ work flow, adding little value to delivering better care. This is more than mere lack of insight on behalf of software engineers and points to a more important barrier to smart health IT design where the needs and changing requirements of third parties (i.e. insurance companies) often supersede that of patients and doctors. As a result, most health IT systems end up being clunky billing machines, focusing mostly on capturing data that satisfy the needs of payers and regulators, not providers and patients. Enhancing the doctor-patient relationship, the foundation of delivering effective care, has rarely been the focus of health IT. Neither has been capturing and analyzing data that can have a positive impact on clinical outcomes.
I think practical health IT should be Intelligent, Integrated, and Interoperable. Intelligently designed systems prioritize the needs of patients and providers. An electronic platform with well-integrated features ensures a consistent and smooth operator experience. Interoperability stands as a prerequisite to deriving real societal value from health IT and facilitates health information exchange among networks of patients and providers.
The current IT Healthcare Systems are ineffiecient for front-line workers in exchanging information. Based on empirical evidence IT Systems are poor tools for establishing care giver/provider handoffs, streamlining workflow, and being able to determine where the system is ahead or behind. I believe that if IT Systems were more efficient in these principles there would be a greater interest for implementation.
I’m awaiting surgery for a kidney cancer found during emergency treatment for a pulmonary infection. An hour in the emergency room which failed to notice the cancer,or to diagnose the pneumonia/pleurisy billed Medicare and Horizon $4100.
The kidney tumor appears in 10 x-rays, MRI’s AND CAT scans over the past two years, but was never noticed until my pulmonary treatment last month.
The radiological service charged hundreds for each
picture.
Every bill they sent out was punctual and to the correct address.
The trouble with medical delivery is that physicians in well insured communities can make so much money per second they cannot take time to observe and think. They quadruple book every second of the day.
The trouble with medical delivery is that pharmaceutical companies have monopolies main-tained by powerful lobbies.
The trouble with medical delivery is that insurance companies ,physician-owned medical diagnostic technology and hospitals are run like auto companies with ridiculously high paid executives seeking primarily to elevate stock prices for shareholders, not to give service.
Do all Americans have a right to the medical care they need? Then some guts are required to dismantle monopolies, and either limit prices or radically tax excess profits, personal or corporate.
The argument is frequently made that such inter-ference will discourage research & development?
Rarely do you hear of what enormous percentage of current research is funded by NIH and other government agencies?
Let’s cut the crap. Runaway prices are the problem and every other civilized country has dealt better than the USA.