Thursday, April 26, 2007

Convergence II

Those who would like to understand why information technology has had so little impact on the cost and quality of health care can get a clue by reading the Convergence II section of the chapter entitled The Triple Convergence in Thomas L. Friedman’s best-selling book The World is Flat.

I ignored the book for a time because of my annoyance with Mr. Friedman for being an apologist for the War in Iraq when I thought he knew better. But when it stayed on the best seller list for two years, and when people I respect continued to recommend it to me, I swallowed my bile and bought a copy. I’m glad I did.

Convergence II is based on the principle that, in Friedman’s words “introducing a new technology….is never enough to boost productivity. The big spurts in productivity come when a new technology….is combined with new ways of doing business….” He cites a number of examples to support his point.

In other words, as long as doctors and nurses and hospitals continue to do what they have always done in the ways that they have always done it, adding computers to the mix doesn’t help much and can even make things worse.

So if information technology is to play a useful role in the reform and redesign of our health care system, health care leaders have to imagine the new and more efficient ways of providing care that computers make possible and then overcome the barriers that stand in the way of implementing them, including the entrenched culture of health care, its professional guild system, and public support of both.

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