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IT and Health Care
Punk CPA writes "Technology Review has some thoughts about why the health care industry has been so slow to adopt IT, while quick to embrace high technology in care and diagnosis. Hypothesis: making medical records available for data analysis might expose redundancy, over-testing, and other methods of extracting profits from the fee-for-service model. My take is that it might also make it much easier to gather and evaluate quality of care information. That would be chum in the water for malpractice suits."
The nugget of this is not explained really in the article:
Cost is *NOT* the barrier, but "lucrative business model hidden" what they mean is the intrinsic structure of how medical care is delivered and who gets to be responsible for care delivery.
In my opinion, refusal to openly adopt electronic medical records is a direct result of overt protectionism by physicians and surgeons. For good reason, society has left medical care in the hands of competent, trained people. However, competency and training has been industrialized to only 1 kind of person, with one kind of standardized training: the MD, and basically no one else, regardless of training or ability is allowed by license to practice medicine, or reap the financial rewards of such extreme responsibility. NPs have wiggled their way in a bit and DOs are close, but basically no one else.
When physicians are required to interact in electronic, shared systems, they can't lord over all the responsibility in care environments, and then they won't be the only ones who run all the medical care and take home most all the money. They will lose their self-created and maintained monopoly on responsibility for care.
Anyone who has worked a hospital environment learns in the first few weeks exactly what the MD care delivery scheme is all about.
I had an interesting experience in China. In 1996, when I received treatment, I kept my own records (they gave me a little paper booklet). This eliminates all the record keeping costs of the doctors and hospitals.
It might be an interesting model to look into here.
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Your reasons 3 and 4 contradict each other.
It means you don't get to see the physician twice, and learn about each other so they can tell when you're lying and you can tell when they're full of horse pucks. And it means that you can't organize your visits to arrange for expensive, long-term treatments for those chronic conditions like sleeplessness, work-related stress and RSI, diet and lifestyle changes. It's also a way to avoid providing mental care, which is very dependent on generating trust and non-verbal communication between a therapist and a patient.