As Congress debated the future of the American healthcare system, a common point of discussion was the benefit of computerized medical records. But a study suggested that the cost savings would be “nonexistent.”
An article in Pacific Standard delved into this medical records problem:
A RAND Corporation study estimated the savings from electronic medical records would be about $77 billion a year. The Center for American Progress added the federal government would save $196 billion over the next decade. The Obama administration has made the argument — probably because of its consensus appeal — a focal point of its health care pitch going back to the 2008 campaign. The whole idea just seems, well, common sense.
Not to spoil a good holiday week (and a rare hiatus in the health care wrangling in Washington), but a new Harvard study suggests all of these claims are simply wrong. Health “information technology,” the research concluded, has yielded neither substantial efficiencies nor any real savings at the U.S. hospitals that today use various forms of it.
“In my everyday work with a computer system at my hospital, which is one of the widely distributed ones, I go through probably a couple hundred unnecessary mouse clicks a day that are there purely for billing purposes,” said David Himmelstein, a Harvard professor and one of the authors of the study, alongside Adam Wright and Steffie Woolhandler.
Whenever he sees a patient, for example, he must answer these questions: Did he have to use an interpreter? If so, was the interpretation done face-to-face or over the phone?
“That’s purely because the hospital can be reimbursed by some insurers a bit more if I have an interpreter,” he said.
In one sense, this software actually does the opposite of what many of us assume. Rather than help anyone save money, it helps maximize the hospital’s ability to collect money from patients and insurers.
When asked why so many of us assume this to be true when it’s not, Himmelstein deferred to a YouTube clip of a cheery 1961 promotional video touting the endless promise of electronic medical records:
“We’ve been convinced,” Himmelstein said, “by a 40-year marketing campaign and our own wishful thinking. We wish that there were a quick, easy solution that didn’t actually involve any difficult political decisions for how we’re going to save money for health care and improve the quality of care,” he said. “That’s part of what would be lovely about computers – gee, we don’t have to do anything but install this machine and solve all these problems.”
It seems shocking to suggest that four decades of technology advancement have had no impact on electronic medical records. Computer systems are supposed to make our lives easier, but they often have the opposite effect.
There are many reasons why this occurs. In the case of patient data, the stakeholders who design the system don’t necessarily have the same goals as those who use the system. Hospitals want to maximize billing so medical record tools ask lots of “just-in-case” questions, such as whether or not an interpreter was used during the consultation. But doctors and patients want the system to be efficient, not highly profitable. This conflict creates friction, and is part of the reason why these technologies still have a long way to go.
If computer systems seem to be working against you at your place of business, don’t be afraid to question whether computers are even the right tool. Take a step back, look at the larger issues of stakeholder needs and try to engage people directly. And if you’re ready to ask for help, reach out to the consulting team at AccelaWork. We help organizations become more productive and more satisfied.