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Friday, October 29, 2004

Still No Vision for IT in Health Care

Anyone who wants to understand why the health care system has been so slow in exploiting information technology needs to look no farther than the round table discussion reported in the October 2004 issue of the journal H&HN (Hospitals and Healthcare Networks). With the sponsorship of GE Healthcare, The American Hospital Association and its subsidiary Health Forum convened a panel of 11 health care leaders, including several CEO’s of major health care institutions, to discuss “The CEO and the Future of Technology” with “technology” in this case referring to information technology.

Reading the report, it occurred to me that there must have been a day in some airline company when a senior executive became aware that computers made it possible to save big chunks of money by getting passengers to make their own reservations, write and pay for their own tickets, and issue their own boarding passes.

Similarly, there must have been a day when Sam Walton realized that computers would allow his suppliers to monitor the sales of their products in Walmart stores and manage Walmart’s inventory of their products. This would make hordes of buyers and inventory clerks redundant while making sure that store shelves were always stocked.

The introduction to the H&HN report talks about the CEO “shaping the direction of…..information technology for the organization.” That is not what the airline executive and Sam Walton did. They shaped new and previously impossible directions for doing the work of their organizations and used information technology to make it happen.

An example in of such a vision in health care would be to have Physicians’ Assistants and Nurse Practitioners provide direct care to heart attack patients, using computer-supported protocols remotely monitored by cardiologists, thereby reducing cost and improving quality. This is essentially the prevailing arrangement in Emergency Medicine, where technicians provide direct care and treatment in the field with backup from doctors who remain at the hospital.

There was nothing in H&HN report to indicate that the people on the panel had anything of this nature in mind. But until they do, the application of IT in health care will be mostly for show with high costs and low returns.

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