Health Information Technology Study
Health IT works well when it is chosen by entrepreneurs to help make their business models successful.
It does not work well and, in fact, often backfires when it is forced on doctors and other providers by their employers and other bureaucracies.
There’s more on how to get the incentives right, and wrong, in a new NCPA study: Health Information Technology: Benefits and Problems.
Very good point. Of course, ObamaCare is going at this the wrong way — top down, force it on the doctors and other health care workers whether they want it or not.
Ken, that the same way we got the entire Obama Care package to begin with –something people did not want, forced upon them.
Back of the envelope calculations suggest that 90% of the effort required to get a beneficial Health IT system up and running has nothing to do with IT. Rather, it’s reengineering the clinical workflow and processes to take advantage of the benefits Health IT offers.
It’s much more complex than merely plopping a computer down on a desk in the exam room, loading software and connecting it to the Internet. Just imagine sitting in the exam room describing your symptoms and asking questions, while your doctor struggles to find the appropriate check boxes and pull down menus on multiple pages with his or her face buried in the screen.
In both health care and education something happens that does not happen in any other market. You have hundreds (no thousands) of people who want to tell the producers how to produce their products.
A very balanced and convincing report. One of the frustrating things about those who advocate unlimited government is that they observe an effective example of a behavior and reflexively conclude that the “government” should therefore command it to occur universally.
The major problem is not the behavior itself, but who is trying to make it happen. A classic example is represented by an article in the Wall Street Journal on March 14 by Chester A. Finn, Jr. (http://tinyurl.com/ylduvzp). Mr. Finn observes that Chinese students perform better than U.S. students; and that they spend more hours in school. He cites the successful KIPP charter schools in the U.S. as exemplars of longer hours leading to better outcomes.
It’s a well written article but leads to the general conclusion that kids should be in school on Saturday. Who will make that happen? The U.S. Department of Education could give grants to states to keep their schools open on Saturday but that would not solve the problem one bit because government would still be in charge of the schools.
Another example (perhaps apocryphal but illustrative nevertheless) is the former Malaysian Prime Minister, Mahathir Mohamad, who ordered the world’s tallest buildings to be built in Kuala Lumpur. He had noted that New York was the world’s most wealth-producing city; and that it had lots of skyscrapers. So, if his government could succeed in building bigger skyscrapers, Kuala Lumpur would become similarly productive!
“Health IT” is neither the problem or the solution. “Who” decides when, where, why, and how to invest in health IT will decide its success.
I took the time to read it. Very good study.
My GP, my eye doctor, and my dentist (and my orthodontist, come to think of it) are all computerized now.
The benefits are instant:
1) Every time I have my teeth x-rayed, I can view the image within seconds on the screen. No waiting for xrays to develop. All of the records are stored online and can be sent from dentist to ortho with a click of the mouse.
2) My doctor has mastered the laptop. Although he asks about 10,000 questions related to my health, I think it leads to a more thorough physical. And he doesn’t have to worry about reading his own writing.
3) Of the three, the orthdontist does the best. They seem to track waiting room times. Every time I’m in the chair, I can see all of my records, dating all the way back to day one. It’s easy to use, and there’s no file to keep up with.
I think that in less than a decade, it will be standard to use electronic records. It’s just a matter of time. Part of it is making the system standardized. The other is making sure mistakes are corrected and systems are integrated. But these bugs will be fixed eventually.
And hopefully, it will be the free market to do it!
Great monograph, btw.