The Growing Role of Information Technology in Healthcare

The following article (from Medscape) was suggested by regular reader and contributor, Dr. Scot Mountain. The author, Dr. Blake Lesselroth, makes some very powerful arguments in terms of the role of technology in healthcare. Earlier today, I had an opportunity to speak at the 43rd Annual Post Graduate Review in Family Medicine Conference in Vancouver. I presented on the role of information technology and how physicians fit into the bigger picture of eHealth. The discussion led to a very interesting and wide range of topics. What is evident when speaking with physicians in 2008 vs. 1998 is the inevitability of EMR/EHR in healthcare and degree to which it is now accepted as a part of medical practice for some and soon for many.

"I believe individual physicians must intervene to catalyze the national adoption of electronic health records, or EHRs.

Research has shown that EHRs are slow to penetrate our healthcare landscape despite the potential benefits, including better quality, error reduction, and $80 billion annually in cost savings.[1-4] Although the federal government has begun investing in EHRs, widespread diffusion has been thwarted by misaligned financial incentives and a fragmented healthcare infrastructure.[5,6] More importantly, there has been cultural resistance among physicians citing issues of poor usability and awkward workflow design.[2,7-9]

Virtually every other industry has exploited technology and, in turn, captured a market premium. Apple changed multimedia; Amazon revolutionized retail; and Google democratized access to knowledge.[10] By contrast, EHR interfaces tend to be faithful representations of paper records. We must therefore ask how we can do better than paper if we are to capture the clinician's imagination. Three things must happen. First, the record must include tools, such as information filters, and preappraised resources to address pressures of a busy practice.[7] Second, we need context-dependent decision aids to support problem solving.[11] And third, we should borrow innovative ideas from other industries.

What if clinical histories were depicted using multimedia, and therapeutic interventions were represented using graphics? What if patients updated their data using automated kiosks like patrons at an airport? Technology has leveled the playing field, empowering individuals to develop and distribute new innovations. Now every provider is positioned to be a visionary and reimagine the EHR. This can be done several ways. Health policy advocates and federal administrators can finance and support open source development communities.[12] Clinical educators can include bioinformatics in their curriculum.[13] And frontline clinicians can avail themselves of the IT literature to inform product design and pilot new technology. The provider working at the intersection between technology and medicine is destined to reinvent the health record and drive adoption.

That's my opinion. I'm Dr. Blake Lesselroth, Portland Oregon VA Medical Center."

http://www.medscape.com/viewarticle/570116?src=mp (requires a Medscape Account)

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Comments

[Ian Furst]

I've invested heavily in health care IT in our clinic (VoIP, some EMR, digital radio, elect patient flow, etc...) and I'm still not convinced that complete EMR is ready. Our hospital uses a non-windows version that is an absolute PITA to use and slow's everything down with the argument of accuracy and portability.

The problem, as I see it, is two-fold. To have EMR work quickly you really need a tablet with wireless connection otherwise constant login/logouts and finding the correct screen will cause work flow issues. Second the programming has been good but the forms (front end) have been bad. Companies are just coming out with programs that work well and flow well. When the IT/programmers spend some time moving from patient-to-patient and setting their standard at the same speed as the written chart I think we'll see the move. Until then they are going to meet resistance from everyone except the early adopters.

By the way - great blog I've added to my list and look forward to reading it. If you think it appropriate will you take a look and/or link back. All the best. Ian.

[Peter V Richards]

Here's a link that puts the funding of EMR's in context.

Link: AMNews: March 10, 2008. Insurer finds EMRs won't pay off for its doctors ... American Medical News.