Right now, the technology exists to completely transform healthcare.
A doctor should be able to walk into the room where a patient is waiting for them and get everything they need to make an informed decision about that patient’s care.
Location-based technology should sense the doctor approaching and already know which patient is waiting for them. A computer or a tablet in the room should have access to thousands of data points on that patient (past hospital visits, surgeries, and allergies, the results of recent tests such as x-rays or cultures, the notes of the nurse who just triaged them) and yet be able to synthesize that data in such a way that is useful to the doctor. Relevant assessments of risk, such as the TIMI score of a patient who is complaining of chest pain, should be automatically fed to the screen. Artificial intelligence should make a suggestion to the doctor on a possible diagnosis, while providing them ready access to the information they need to explore other possibilities.
The thing is, information technology in other areas of the economy is already achieving this level of intelligence, interoperability, and ease of use. After all, this is the year that Twitter did a better job than the CDC at predicting the spread of the flu. Each smartphone we carry around in our pocket now has more computing power than Apollo 11 did when it landed on the moon.
And yet, information technology in healthcare is still stuck in the 1980s. As an emergency room physician, I can attest that the technology we do have does more to slow me down than help me deliver better, more efficient care. The past few weeks have seen a number of stories and studies questioning the value of EHRs. As one story from HIT Consultant notes, recent studies have shown EHR implementation “upends organizational structure and often slows down the provision of care,” and tends to exacerbate existing dysfunction rather than alleviate it. Meanwhile, patients don’t appreciate their doctors looking at a screen rather than at them, and doctors don’t appreciate having their practice slowed by data entry that, in the end, doesn’t help them deliver better care.
Make no mistake, though: the potential of information technology will one day transform healthcare for the better. The kind of user-friendly, interoperable, connected system I described will decrease medical errors, dramatically reduce unnecessary care and testing, and help doctors provide more effective patient-centered care. We’re just not there yet.
Dealing with information technology in healthcare today is like operating an automobile just after they were invented. Truth be told, it was still more efficient to ride your horse into town than take your car, just as doctors still reach for their paper and clipboard even when a tablet is available. The first cars broke down all the time, moved too slow, and were too expensive to operate. But eventually they caught up and far surpassed the tools they replaced – and so will healthcare IT.
It’s no secret why we’re stuck in the past. The incentives in healthcare – a healthier population still means less revenue for most hospitals – are more likely to discourage the sort of multi-million dollar investments in technology that could help deliver better patient care. Even so, cost pressures and healthcare reform are starting to shift incentives (New Medicare rules that penalize hospitals for re-admissions is a good example).
As incentives shift, so will investment dollars start flowing into healthcare IT. Forbes recently called this “Healthcare’s Trillion Dollar Disruption.” Reporting on the recent Startup Health Summit, Forbes states that, “the opportunity in healthcare is so big that most startups are thinking too small.”
So to all those doctors on the front lines and healthcare leaders frustrated with the pace of change: don’t give up on it. One day, our EHRs will be so sophisticated that we’ll look back nostalgically on the heady days when we used to grasp for our clipboards rather than deal with a health IT that only goes 10 mph and is less reliable than our horse.
Michael Cetta is an emergency physician who blogs at the EmergencyDocs Blog.