Monday, September 16, 2013
Health Information Technologies and the War on Costs and Disease
It has become appalling obvious that our technology has exceeded our humanity.
Albert Einstein (1879-1955)
Humanity has acquired all the right technology for all the wrong reasons.
R. Buckminster Fuller (1895-1983)
It’s not faith in technology. It’s faith in people.
Steve Jobs ( 1955-2011)
The Washington policy elite have declared technological war on health costs and disease. The promises of health information technologies are that these technologies will:
· Make health delivery more efficient by making patients and physicians more productive by connecting everyone and making costs more transparent.
· Document health care transactions through a universal interoperative electronic health system that will compare costs and outcomes and demonstrate what works and doesn’t work.
· Render health care more “virtual” and “accessible” by not requiring the physical presence of patients before doctors, i.e., “boots on the ground,” and in many instances, allow patients to treat and monitor themselves.
These are very seductive thoughts. Many are already “in play” with technologies like Skype and its variants, smartphones and other medical devices allowing remote communication and monitoring, organizational telemedicine systems, and growing adoption of electronic health records by doctors.
But somehow it isn’t all working out as planned or envisioned. The health law remains deeply unpopular, confusing, and met with low expectations. Inevitable glitches keep cropping up. Government computer systems need to be integrated and debugged. Pay-for-performance and comparative outcome systems fail to save money or improve outcomes. Every high tech system calls for a high touch counterpart. Costs continue to rise. Doctors and health systems find ways to avoid “transparency.” Physician shortages loom. New Medicare and Medicaid patients can’t find doctors. Patients complain of loss of privacy. Hackers hack into security systems and steal personal identities. Fears of fraud and abuse related to the health law keep surfacing. People tire of menu-driven telephone response systems and want to hear human voices just like in the good old days.
People yearn for more human warmth and more primary care physicians listening to and responding to their complaints and questions. Three federally appointed National HIT Coordinators of electronic health record systems leave their jobs in frustration. Doctors chaff at the thought of being forced to adopt and pay for EHRs whether they need these systems or not. Doctors complain of lack of time with patients and of wasting time learning the ins and outs of computer data entry and the expense of hiring staff to meet federal regulations.
Somehow, someway, it will work out for somebody somewhere, just not everywhere. It always has.
Tweet: Health information technologies as a war on health costs and disease outcomes are a mixed blessing. Boots on the ground are still needed.
Posted by Richard L. Reece, MD at 11:50 AM
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