Friday, July 23, 2004
Bringing medical technology up to speed
[Julie Schmit, "Health care's paper trail is costly route," USA Today, 19 July 2004.]
With the increased presence of technology in medicine - MRIs, laser surgery, and a host of other applications - it is easy to assume that the medical community is ahead of the curve. When it comes to paperwork and record-keeping, though, the industry has fallen behind. Research indicates that adapting new technology can lead to gains in effeciency and significant savings. But the hurdle that remains is the cost of such a transition:
Technology has cut costs and increased productivity in industry after industry.
But health care, a $1.6 trillion beast that wallops business and consumer pocket books more and more, still largely runs on paper.
Visits to new doctors require patients to fill out forms for the same old information. Getting test results from one office to another can take days. That often leads to duplicate tests, excess costs and poor care.
Based on tech's impact on other industries, John Chambers, CEO of Internet titan Cisco Systems (CSCO), says technology could cut health care costs by at least 25% — and improve care. In May, President Bush set the goal for every American to have an electronic medical record, instead of the traditional stuffed manila folder, within 10 years. At the same time, he named David Brailer to the new position of national coordinator of health information technology.
On Wednesday, Brailer is expected to announce government plans to nudge the industry forward. In the past 18 months, lawmakers introduced at least five bills pushing health care tech ideas.
It won't be an easy fix, though. Billions in investments have been lost on health care tech. The reasons are many. Health care is a huge, fragmented industry: 700,000 doctors; 5,700 hospitals. Each piece collects data its own way. Existing systems don't talk to each other. More common standards are needed. Privacy has been a concern.
The biggest reason, though, is economic. Doctors and hospitals bear the cost of new hardware and software. Their productivity suffers when they change decades-old work processes. But those who pay for care, insurers and employers, get the first financial benefit because of increased efficiency and fewer costly errors.
For many doctors, "the economics don't work," says John Glaser, chief information officer of Partners HealthCare System in Boston. Yul Ejnes, an internist in Rhode Island, uses computers to process office bills and appointments. He banks online. But Ejnes still uses paper medical charts for patients. Existing software is too hard to use, he says. Then there's the cost — "$10,000, $20,000 or more per doctor," he says. Sure, he'd eventually benefit. But the real financial gain would go to insurers, hospitals and others. "And they're not paying anything for it."
More than 90% of the 30 billion health care transactions done annually occur via phone, fax or paper, says the eHealth Initiative, a non-profit formed to spur tech adoption. While 90% of physicians in Sweden and the Netherlands use electronic patient medical records, fewer than 20% of U.S. primary-care physicians do, the same percentage as Greece, says market researcher Harris Interactive.
Health and Human Services Secretary Tommy Thompson estimates the USA could save $140 billion a year using more tech. That's a lower estimate than Chambers', but about equal to Mexico's '04 federal budget.
More important, tech could improve care. The Institute of Medicine in 1999 called medical errors one of the nation's leading causes of death, citing studies that they resulted in 44,000 to 98,000 deaths a year in U.S. hospitals. If doctors adopted computer systems that not only replaced paper records but also warned if a drug prescribed to a patient might interact badly with another they're taking, 2.1 million fewer patients would suffer drug reactions, says a 2004 study by the Center for Information Technology Leadership.
While every effort helps, wide-scale tech adoption won't hit critical mass until the federal government changes how it pays for health care, Glaser says.
The government — via programs such as Medicare and Medicaid, and as a big employer — pays for more than one-third of all U.S. health care. Often, it rewards doctors and hospitals to do more tests, not less. It doesn't reimburse doctors for e-mail consultations, thereby encouraging more visits.
In May, Sen. Edward Kennedy, D-Mass., introduced a bill that would link Medicare payments for the first time to the use of technology. Hospitals that do, and meet other goals, would eventually get higher federal financial reimbursements than those that don't.
[Julie Schmit, "Health care's paper trail is costly route," USA Today, 19 July 2004.]
With the increased presence of technology in medicine - MRIs, laser surgery, and a host of other applications - it is easy to assume that the medical community is ahead of the curve. When it comes to paperwork and record-keeping, though, the industry has fallen behind. Research indicates that adapting new technology can lead to gains in effeciency and significant savings. But the hurdle that remains is the cost of such a transition:
Technology has cut costs and increased productivity in industry after industry.
But health care, a $1.6 trillion beast that wallops business and consumer pocket books more and more, still largely runs on paper.
Visits to new doctors require patients to fill out forms for the same old information. Getting test results from one office to another can take days. That often leads to duplicate tests, excess costs and poor care.
Based on tech's impact on other industries, John Chambers, CEO of Internet titan Cisco Systems (CSCO), says technology could cut health care costs by at least 25% — and improve care. In May, President Bush set the goal for every American to have an electronic medical record, instead of the traditional stuffed manila folder, within 10 years. At the same time, he named David Brailer to the new position of national coordinator of health information technology.
On Wednesday, Brailer is expected to announce government plans to nudge the industry forward. In the past 18 months, lawmakers introduced at least five bills pushing health care tech ideas.
It won't be an easy fix, though. Billions in investments have been lost on health care tech. The reasons are many. Health care is a huge, fragmented industry: 700,000 doctors; 5,700 hospitals. Each piece collects data its own way. Existing systems don't talk to each other. More common standards are needed. Privacy has been a concern.
The biggest reason, though, is economic. Doctors and hospitals bear the cost of new hardware and software. Their productivity suffers when they change decades-old work processes. But those who pay for care, insurers and employers, get the first financial benefit because of increased efficiency and fewer costly errors.
For many doctors, "the economics don't work," says John Glaser, chief information officer of Partners HealthCare System in Boston. Yul Ejnes, an internist in Rhode Island, uses computers to process office bills and appointments. He banks online. But Ejnes still uses paper medical charts for patients. Existing software is too hard to use, he says. Then there's the cost — "$10,000, $20,000 or more per doctor," he says. Sure, he'd eventually benefit. But the real financial gain would go to insurers, hospitals and others. "And they're not paying anything for it."
More than 90% of the 30 billion health care transactions done annually occur via phone, fax or paper, says the eHealth Initiative, a non-profit formed to spur tech adoption. While 90% of physicians in Sweden and the Netherlands use electronic patient medical records, fewer than 20% of U.S. primary-care physicians do, the same percentage as Greece, says market researcher Harris Interactive.
Health and Human Services Secretary Tommy Thompson estimates the USA could save $140 billion a year using more tech. That's a lower estimate than Chambers', but about equal to Mexico's '04 federal budget.
More important, tech could improve care. The Institute of Medicine in 1999 called medical errors one of the nation's leading causes of death, citing studies that they resulted in 44,000 to 98,000 deaths a year in U.S. hospitals. If doctors adopted computer systems that not only replaced paper records but also warned if a drug prescribed to a patient might interact badly with another they're taking, 2.1 million fewer patients would suffer drug reactions, says a 2004 study by the Center for Information Technology Leadership.
While every effort helps, wide-scale tech adoption won't hit critical mass until the federal government changes how it pays for health care, Glaser says.
The government — via programs such as Medicare and Medicaid, and as a big employer — pays for more than one-third of all U.S. health care. Often, it rewards doctors and hospitals to do more tests, not less. It doesn't reimburse doctors for e-mail consultations, thereby encouraging more visits.
In May, Sen. Edward Kennedy, D-Mass., introduced a bill that would link Medicare payments for the first time to the use of technology. Hospitals that do, and meet other goals, would eventually get higher federal financial reimbursements than those that don't.
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