Earlier today I almost had a brain aneurysm. I was sitting in the offices of an important health care facility when the subject of electronic medical records (EMR) came up. What I heard uttered out of the mouth of a highly talented and solidly experienced health care professional made me realize just how bogged down in the 20th Century our health care industry has become:
What do we do if the computers go down?
Now this is an obvious concern. But it occurred to me that this line of reasoning is a deep-seated logos in the health care profession. I wanted to ask this person what the facility would do if the electricity would fail. I’m pretty sure I would hear “Well, our backup generators would kick in.” Why hasn’t this kind of acceptance of electric backup grown with respect to other kinds of technology? If we all followed this person’s logic, why wouldn’t we just go back to using gas lamps in hospitals?
What is the source of such fear? Why is our health care system so behind in the proper management of health information? Do we even know what are the economic and social opportunity costs of using paper for the majority of our health information?
A PAPER DRAGON BY THE FLAME
According to some studies, less than 10% of health care facilities in the US employ health information technology (HIT). 90% of of the health information is on paper! Is it 2008? Is this the 21st Century?
I know there are many reasons for the delay: federal and state regulations, privacy concerns, reliability, cost, etc. These are all major considerations. Something tells me, though, that even if these concerns were addressed an allayed, there would remain perhaps the single largest Dip our health care industry would have to get up and over: culture.
Social media geeks are all coked up about Twitter and FriendFeed and many other white lines on the web, but what could be more geeky than healthcare? I’ve worked in the ICU and the technical geekiness required to safely titrate a vasopressor or manage ventilator settings is far more wicked than anything on the web. If health care workers can learn these gadgets to save lives and restore the sick to wellness, what gives? Why such a gap in using health care data with as much comfort as using Google or any other informational interface?
THE OPPORTUNITY COST OF GAS LAMPS
We live in a time when cost containment is being addressed by folks who aren’t thinking about the consequences of their decisions. Refusing to reimburse facilities for Hospital-Acquired Complications (HAC) is admirable and understandable. Ultimately, however, facilities will need to start documenting care for the primary benefit of payors instead of patients. Those facilities that rely on paper to document events, in turn, will place the burden of this kind of documentation on health care workers.
When does this deadly game end? When will the body count be sufficient for this Pagan God of cost efficiency? The opportunity cost of paper documentation is quality care. Period. The right ideas in the wrong heads are always dangerous.
If our health care system is still burning gas lamps in an age of light bulbs, how blind our we getting? Time for some eyes to open up. The dusk is coming and the lamps are buring low.