Harvard Says Computers Don't Save Hospitals Money

Lucas123 writes "Researchers at Harvard Medical School pored over survey data from more than 4,000 'wired' hospitals and determined that computerization of those facilities not only didn't save them a dime, but the technology didn't improve administrative efficiency either. The study also showed most of the IT systems were aimed at improving efficiency for hospital management — not doctors, nurses, and medical technicians. 'For 45 years or so, people have been claiming computers are going to save vast amounts of money and that the payoff was just around the corner. So the first thing we need to do is stop claiming things there's no evidence for. It's based on vaporware and [hasn't been] shown to exist or shown to be true,' said Dr. David Himmelstein, the study's lead author."

Comments

Transferability

[oldhack]

Well, that's mouthful, but with electronic records you can at least switch doctors without having to take X-rays, tests, and other records again. No?

Re:Transferability

[MattSausage]

As a personal anecdote, computerized medical records most likely saved my father's life.

He woke up in the middle of the night with unbearable pain in his abdomen, and when he didn't fight my mom about going to the hospital she knew it was serious. Five hours later and untold scans and prodding later (not to mention a significant amount of morphine) they determined a blood vessel leading to my father's colon had been blocked and basically part of his colon was dead or dying. Not having the facilities or expertise to handle the necessary surgery in my mid-size town of Owensboro, KY, they sent him to the University of Louisville Medical center telling us that basically, even done by the best surgeons in the business there is a 3 out of 4 chance he wouldnt' make it through surgery unless it was done in the next few hours. The trip to Louisville takes two hours. Following the ambulance we arrived in Louisville in an hour and a half, and he was in his room and being prepped when the doctors realized they didn't have any scans of his abdomen, the EMTs had left them behind in their rush to get us all there. Faxing them was the only option, and to do that they would have to get in touch with someone in Owensboro, convince them who they were, have them look up the records, and then get them to a fax machine that could handle the scans. It could take another hour.

Except my mother (who, frankly, is the smartest person I know) insisted that she be given a copy of the CD with all the electronic scans and data the doctors had collected that morning. I thought the surgeon was going to kiss her. 20 minutes later my father is in surgery, and 5 hours after that (or so, it was a long day) he was back out and kept in ICU for two weeks before finally coming home. The doctor had said if he'd had to wait much longer chances would have shot up considerably that my father would have died. So, there is at least one example of how Electronic Medical Records did help a doctor save a life.

The key being ...

[devloop]

"IT systems were aimed at improving efficiency for hospital management"

Doctors and other medical personnel do not typically hold much power
when it comes to IT.

Software vendors aim to please management, they are the ones who take
the purchasing decisions.

Your typical Lab software for example might not have a straightforward
way to cross-check isolates for emerging resistance trends,
run critical screens or automatically report to a global EPI database,
but it sure has 1,000 ways to generate Aging Reports and auto resubmit insurance claims.

building bad clinical systems is harder

[r00t]

We are over ambitious. The more code we write, the more bugs we create.

The trouble with hospital data is that it is messy. You have to accept that.

It's tempting to design a hospital data system with specific fields for each item, every procedure enumerated, and every field validated. You want to normalize your data. You want it neat and tidy. You can work very hard trying to enforce this. You're screwed though, because life isn't like that.

You'd be better off with relatively "dumb" software, almost like a wiki, that lets you efficiently handle arbitrary text and arbitrary data blobs. It needs fast Google-style search. It needs to allow arbitrary associations so you can handle stuff like a patient claiming to have the same social security number as a different patient or a patient who claims to have a different identity than he did the last time he visited.

Then you need to keep medical staff away from both paper and computers. Data entry is for data entry specialists.