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Technology Is Making Doctors Feel Like Glorified Data Entry Clerks (fastcompany.com)
An anonymous reader writes from a report via Fast Company: The average day for a doctor consists of hours of data entry. Since the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 took effect in January of 2011, which incentivized providers to adopt electronic medical records, hospitals have spent millions, sometimes billions, on computer systems that weren't designed to help providers treat patients to begin with. The technology was supposed to reduce inefficiencies, make doctors' lives easier, and improve patient outcomes, but in fact it has done the opposite. "Frankly, the main incentive is to document exhaustively so you cover your ass and get paid," says Jay Parkinson, a New York-based pediatrician and the founder of health-tech startup Sherpa. The systems are flooding doctors with important and utterly meaningless alerts. One of the biggest problems is that the systems have made it very difficult for doctors to share information between one another, which is what the systems were intended to do all along. Why? "Because it doesn't help the bottom line of the biggest medical record vendors or the hospitals to make it easy for patients to change doctors," reports Fast Company. Since it often takes weeks, or months for data to be sent to and from facilities, that, according to Consumers Union staff attorney Dana Mendelsohn, increases the chances of doctors ordering duplicate tests. All of this reduces the time doctors have with their patients. A recent study shows that the average time doctors spend with their patients is about eight minutes and 12% of their time, down from 20% of their time in the late 1980s. "This group is 15 times more likely to burn out than professionals in any other line of work," reports Fast Company. "And much of the research on the topic concludes that 'documentation overload' is a key factor." To help alleviate this pain, medical groups are working to reduce the data-entry burden for doctors, so they can in turn spend more of their time with patients.
I have stage 4 cancer and spend a few hours at the doctor's office every month. The phlebotomists spend a solid minute selecting my record, marking off all the tests, verifying id, insurance, etc. The nurses go down the list of 50 prescriptions I have, asking me if I'm still taking them, even when I say nothing has changed. They're all very polite and nice, but the whole system fails at easy things should be easy, hard things should be do-able design. You can tell that no one who designed the system ever actually performed the tasks at hand (or they were bound by absurd requirements). And all that isn't including the massive bureaucracy of insurance or scheduling that will sink days of your time pressing buttons on your phone trying to talk to an actual person.
In my experience american health care is an inefficient, bureaucratic mess manned by very friendly medical professionals.
Burn down the medical schools and start over. As a society, we need to get back in touch with the basic fundamentals of what constitutes healing and caring for one another. What the modern medical establishment has morphed into is an abomination.
Its excellent news that more and more people are able to bypass the medical establishment in various ways and that the remaining vestiges of it have been reduced to frivolities like data entry. Hopefully it will become completely obsolete before long.
Also, you need your tax prepare only once a year, while doctors get a steady stream of patients. In reality you pay to the healthcare industry probably approximately $20,000 in the form of your family insurance premiums and copays. Tax accountant can only get from you your $300 per year.
The human body doesn't change much in a year, nor does medical technology. The IT spending a doctor has to spend isn't so much to improve patient care so much as to align with Federal and insurance company requirements.
IMHO, the tax dude has to deal with bigger changes year over year than my doctor does. My doctor is dealing with insurance and the feds, which have nothing to do with my health. My tax dude is dealing with dumass changes to the tax law. Odds are, if something is really wrong with me then the changes the doctors have to deal with won't affect anything other than who pays for them, or which department of who pays for them. OTOH, having a tax dude who can save me $1k/yr (which my guy has done for 12 years) affects my life more than an insurance classification.
My point is, doctors can no longer view patient outcome as their #1 goal. The goals now are:
1) don't get sued
2) if you get sued prove you did every test imaginable
3) If you don't get sued ensure you billed properly
4) Hope for the best in getting paid
5) Patient? Who? Oh yeah, hope they got fixed.
the constant battles on the part of doctors to get paid by insurance companies who's single goal is to not pay. In no other part of my life are my goals (getting care) and the service provider's goals (not paying for that care) so diametrically opposed. I've got family members with nasty health complications from easily treatable problems that were let go because the doctor didn't want to order tests in case they came back negative. If a test comes back negative the doctors never get paid.
Come to think of it I see this in one other place. B2B transactions. In so many of them business A won't pay the invoice for business B until A needs B's services again. I read somewhere Don Trump is famous for that, but having worked for small businesses it's so common he could just be going with the flow.
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Here is the root problem: America spends 18% of GDP on healthcare. Other developed countries spend 6-9%, yet mostly have better health outcomes. So if we become as efficient as them, 1/2 to 2/3rds of healthcare workers will be redundant. What interest do they have in destroying their own jobs? Our healthcare system will not fix itself from the inside. They have absolutely no incentive to do that.
It depends on their tech setup. One heathcare provider has a workstation in every room, and it takes the doctor about 1 minute to review patient records and a couple more minutes to update it after the exam is over. Another heathcare provider takes notes and transfers them all at the end of the day. Yet another still uses paperwork and is very much not organised.
It depends on their tech setup. One heathcare provider has a workstation in every room, and it takes the doctor about 1 minute to review patient records and a couple more minutes to update it after the exam is over. Another heathcare provider takes notes and transfers them all at the end of the day. Yet another still uses paperwork and is very much not organised.
I don't want to use explictives, but they are warranted to the most extreme degree possible.
This 1 minute talk, it takes that long to login..if the system is polite, then to open the chart, then to find the actual note, then to load the CT scan...
There are multiple hard studies that show 33% reduction in efficiency that cannot be recouped.
Patients just love when you stare at a computer instead of talking to them....
This is crazy, I fight with my nurses every day. They tell me I have to input codes, I have to reconcile X, or Y or whatever.
F. That! I talk to my patients. I deal with them, and I deal with that screaming on the back end, but I'm not typical. I fight to talk to people like I would want to be talked to if I was a patient. I am burnt out, I can't fight forever. They will wear us down, your care will suffer. You let this happen, you asked for it through shitty laws that paid doctors 20% more to be part of a hospital system. You will suffer and you asked for it.
Practicing Surgeon MD
This was your statement:
Pakistan and India both have private medicine. If they're coming here from Pakistan and India, it's not because those countries have universal health care.
And why don't you see doctors from the UK, Canada, Sweden, Denmark, etc etc moving here to make those sweet sweet private $$$? If universal public health care is so horrible for doctors, why didn't they flock here before the ACA?
You are welcome on my lawn.
No, "better healthcare outcomes" is a measurment anomaly. When an American CAN PAY FOR his healthcare, either directly or by insurance, the US healthcare systems beats the pants off the furriners. Where the distortion comes in is that many Americans _can't_ pay for healthcare, so they get limited or no healthcare, and they die at accelerated rates that drag down our average. Our average cure rates suck because the less-well-monied have much worse outcomes, which drags down the average. But if you compare out "best" with their "best", we win, hands down. You don't think all those foreign political leaders and rich business guys fly themselves and their cancers to the USA because we do a worse job, do you?
It's 18% because health is a side benefit of an insurance system.
No, "better healthcare outcomes" is a measurment anomaly.
The fact that the average is dragged down because a large percentage of the US population doesn't get adequate health care is not a "measurement anomaly". It's an epic failure.
It's like a C average student claiming: "I'm really a straight-A student! I got As in all the classes I didn't flunk. (And BTW, for some reason my education cost twice as much as that of any other student.)"
Not really, no. Countries with socialized medicine use the same drugs, the same machines and doctors with the same skills. They just bargain harder to get decent prices on in all. Some wealthy people do choose to fly to the U.S. but that's more about getting to the front of the line faster for elective procedures than anything else.
But even if you're correct, healthcare you can't afford might as well not exist. In that sense, the U.S. has practically non-existent healthcare.
So, the US spends 18% of its GDP on healthcare, but that only covers part of the population. Meanwhile those countries who only spend 6-9% of GDP on healthcare manage to cover everyone. So, that 18-6 cost disparity is actually understated
This is your argument that quality of care in the US is actually the best in the world?
I'm not really sure I care that a US millionaire can get outstanding care, if he can only do so at the cost of forcing the rest of the country to get 3rd-world quality care. I'm sure appropriately rich people in those other countries also get better than local average care. It's ridiculous to compare the quality of care available to the few Americans who can afford it to the quality of care available to an average 'socialized' medicine citizen.
We've had tort reform in some states. The effects seem to indicate that the cost of malpractice is responsible for a few percent of our healthcare costs.
I suspect what's driving our healthcare costs is that good healthcare isn't cost competitive. Our healthcare for most of us is covered by insurance companies through work. We change jobs frequently. Yet health problems can take years to have serious (and costly) effects. It's not cost competitive to prevent a problem that another company will likely end up paying for.
It's like the difference between owning a car you know you'll replace in five years and owning a car you will replace in twenty-five years - you're going to be much more diligent about preventing problems in the car you'll own for five times as long, because you'll be paying for the costly effects of poor maintenance.
Burn down the private healthcare industry and start over. As a society, we need to get back in touch with the basic fundamentals of what constitutes healing and caring for one another.
TFTFY
Nothing, absolutely nothing, has driven modern medicine so far away from the business of healing as has the insurance industry. Google the term "managed care", and weep for the days when physicians and other caregivers decided how to treat their patients. Worried about "government death panels" that decide who gets life saving care and who doesn't? Congratulations, sucker. That blatant misdirection worked on you too. In the U.S. we spend more (far more) and get less (by any credible metric) than any other industrialized nation when it comes to health care. To blame the physicians for this is absurd.
I keep thinking that the people that are the most opposed to universal health care are the insurance companies.