• SHOCKER! Health IT hasn’t reduced costs as much as we hoped.

    From Health Affairs:

    A team of RAND Corporation researchers projected in 2005 that rapid adoption of health information technology (IT) could save the United States more than $81 billion annually. Seven years later the empirical data on the technology’s impact on health care efficiency and safety are mixed, and annual health care expenditures in the United States have grown by $800 billion. In our view, the disappointing performance of health IT to date can be largely attributed to several factors: sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and the failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT. We believe that the original promise of health IT can be met if the systems are redesigned to address these flaws by creating more-standardized systems that are easier to use, are truly interoperable, and afford patients more access to and control over their health data. Providers must do their part by reengineering care processes to take full advantage of efficiencies offered by health IT, in the context of redesigned payment models that favor value over volume.

    Bottom line is that those savings estimates of $81 billion were, shall we say, optimistic.

    Of course, long time readers will not be surprised. Here’s a podcast on EMRs we did.


    • I think you hit the nail on the head with your article from March 2011. The patchwork healthcare system leads to a patchwork healthcare IT system. Different insurance companies using different systems, medical professionals reluctant to change, and so on.

      My educated guess (as someone who works in the software industry) is that greater adoption and ultimately cost savings will take some time. Think, just for example, how long it took schools to switch to electronic systems for registration and grades. Our education system, much like our healthcare system, is fragmented, and change won’t happen quickly. I’m still cautiously optimistic that EMRs can have a net positive effect in the long term.

    • The Pretense of Knowledge.

      The faith of the Left will not be shaken.

    • As another person with experience in software, my take would be that IT almost never saves money, but rather may allow one to provide better service to more people. As I’ve mentioned before, I really like it that when I go to my GP, he’s got everything about me at his fingertips, and checks it. Even when it’s just my now monthly visit to get a new prescription for HT meds, he checks everying I’ve ever complained about.

      IMHO, better service to more people is something that the US really needs to do, in addition to reducing costs, so I’m enthused about IT.

    • There is absolutely everything to be gained by a systematically difined medical record based on modern electronically automated technology. As a primary physician, I am dependent on “flow-sheets” to track health maintenance data, e.g., immunizations, and an over-all care plan, e.g., medications and monitoring data. So far, I know of no EMR that offers automated flowsheets or patient encounter, data-sets driven off a Problem List based on whether health care is intended for Health Maintenance or Crisis Intervention (a new health condition or its follow-up). In addition, I know of no EMR that allows the individual provider group to edit the data sets and flowsheets on a real-time basis, such as for changes in immunization strategies (new products or the almost annual problems of availability for certain products). We have nearly 200 forms for our office “paper record,” all maintained on a real-time basis by our office computer local area network. I won’t even speak about our level of success for preventing down-times over the last 37 years.

      I discuss the theoretical issues with the current EMRs at: http://nationalhealthusa.net/innovation/medical/ It is highly likely that the currently evolving systems based on touch screens, voice activated input and cloud data repositories will soon solve ALL of my concerns, for an affordable price. The last issue is exceedingly important since Primary Health Care is currently undercapitalized to a greater extent that any other segment of the healthcare industry. It is the most important reason why the accessibility, acceptibility, efficiency and effectiveness of Primary Health Care for Basic Health Needs has not kept up with the quality of Specialized Health Care for Complex Health Needs.