Saturday, January 31, 2004
Information Technology and Health Care – Still a Poor Fit
The first time I ever used an e-ticket kiosk was at the George Bush International Airport in Houston. I remember looking across the lobby at the long row of agents checking in passengers with regular tickets and realizing that whoever invented the e-ticket had in mind making those positions unnecessary.
It also occurred to me that the airlines were not simply automating their established routines. Instead, they were using computer technology to perform a function in a new and more efficient way that would be impossible without it.
All of that was brought to mind by the January 27, 2004 AHA News Now (the daily internet news bulletin of the American Hospital Association), which reported as follows:
“Speaking at the World Health Care Congress meeting in Washington, [HHS Secretary] Thompson estimated....that more than $100 billion could be saved by hospitals and other health care providers annually if investments were made in improving information technology in the health care field, noting such an investment also would improve quality of care and reduce the paperwork burden for hospitals.”
A lot of people have been saying something like that for a long time. Unfortunately, doing things in new ways is something the health care industry finds it extraordinarily difficult to do. The guild system that characterizes the health professions, combined with the culture of medicine (in which a 99 to 1 vote is said to be a tie) and the entrenched tradition of professional independence, makes it impractical to consider any computer-enabled innovation that would eliminate large blocks of patient care work or transfer major clinical functions from higher to lower paid staff.
Slowly, slowly that is changing, but it has a long way to go before Secretary Thompson’s vision stands much chance of being realized. In the meantime, health care providers are apt to just overlay computers on their established way of doing things. The result will be that most of the money that gets spent in doing so will end up in the coffers of consultants and IT companies and the cost of care will more likely be increased than decreased.
The first time I ever used an e-ticket kiosk was at the George Bush International Airport in Houston. I remember looking across the lobby at the long row of agents checking in passengers with regular tickets and realizing that whoever invented the e-ticket had in mind making those positions unnecessary.
It also occurred to me that the airlines were not simply automating their established routines. Instead, they were using computer technology to perform a function in a new and more efficient way that would be impossible without it.
All of that was brought to mind by the January 27, 2004 AHA News Now (the daily internet news bulletin of the American Hospital Association), which reported as follows:
“Speaking at the World Health Care Congress meeting in Washington, [HHS Secretary] Thompson estimated....that more than $100 billion could be saved by hospitals and other health care providers annually if investments were made in improving information technology in the health care field, noting such an investment also would improve quality of care and reduce the paperwork burden for hospitals.”
A lot of people have been saying something like that for a long time. Unfortunately, doing things in new ways is something the health care industry finds it extraordinarily difficult to do. The guild system that characterizes the health professions, combined with the culture of medicine (in which a 99 to 1 vote is said to be a tie) and the entrenched tradition of professional independence, makes it impractical to consider any computer-enabled innovation that would eliminate large blocks of patient care work or transfer major clinical functions from higher to lower paid staff.
Slowly, slowly that is changing, but it has a long way to go before Secretary Thompson’s vision stands much chance of being realized. In the meantime, health care providers are apt to just overlay computers on their established way of doing things. The result will be that most of the money that gets spent in doing so will end up in the coffers of consultants and IT companies and the cost of care will more likely be increased than decreased.
