Why Hospitals Don’t Have Electronic Medical Records
This is from USA Today:
An electronic medical record could have 65,000 pieces of information — from blood test results to images from a CT scan. Most hospitals have no real financial incentive to create electronic records, Ashish Jha [of the Harvard School of Public Health] says.
Electronic medical records don’t increase the amount that insurance companies reimburse hospitals for care, he says. In some ways, inefficient hospitals — which perform duplicate X-rays when the first set can’t be found — can actually make more money, because they can charge for each new test, Jha says.
If they were actually competing on price and risked going out of business when money was wasted on redundant tests, hospitals would all have state-of-the-art health information technology (HIT) systems. However, since hospitals are not competing on price (or quality); and because there is a financial disincentive for installing HIT systems that eliminate duplicate tests, it is easy to see why HIT is underutilized in the United States Health Care System. Where systems do exist, they are often silos with limited features rather than robust systems that are interoperable across institutions.
Good point, Ken. They all should ride without helmets.
This is an interesting explanation of why hospitals don’t use them.
If hospitals are profit maximizers, which the economic literature suggests is true even for non-profits when faced with competition, then they would install electronic records if they saved more than their installation costs. In fact, many hospitals have done so.
To say that hospitals don’t put in electronic records because they can make more money losing x-rays ignores the fact that some hospitals have. It also ignores the fact that electronic records are hideously expensive so that for smaller hospitals they simply might not make sense.
I think the broader issue is a point John Goodman has made several times at this blog. Hospitals, like doctors, are not really competing for patients based on price. And when they don’t compete on price, they don’t compete on quality either.
Hospitals do attempt, at least through their marketing, to compete based on quality. However, for most consumers, it doesn’t come down to a price/quality debate at all; it comes down to “which facility/practitioner accepts my insurance?” The quality debate rarely comes into focus at all with our current healthcare costs. Few people can afford to go out-of-network for most routine procedures. Fundamentally, everyone should aspire to provide the best service possible, but there is no rational reason why they should take on the cost of EMRs and absorb the cost (if they even could) simply to provide better care.