Why Health Care Records Are So Low-Tech
27th April 2008
Frequently, when a patient goes to see a specialist for the first time, none of the records kept by his primary care physician are accessible to the new doctor. The specialist will typically order a whole new series of diagnostic tests to ensure the file he starts contains records he can trust, even if the same tests were just performed at the request of the other physician. Not only is this duplication costly, it also undermines quality care, as the patient is in danger of getting conflicting treatment plans based on competing and incomplete patient records.
One of the major reasons health care costs are out of control is that it’s so labor-intensive. We’ve brought the efficiencies (and consequent cost savings) of automation to almost every area of human activity — with the glaring exception of health care and education. With health care, people aren’t willing to sacrifice quality, so the cost goes through the roof. With education, people aren’t willing to spend what it takes to ensure high quality, so quality goes in the toilet. The only way to fix these situations is automation. As with automation in the manufacturing sector, the chief obstacle to overcome isn’t technical, it’s social — primarily resistance on the part of the relevant unions (AMA and NEA, for example).
And, of course, the lack of a free market in both areas is crucial.
The primary payers of medical bills are not the consumers—that is, the patients—but rather insurance plans and government programs like Medicare and Medicaid. Consequently, the normal marketplace dynamic of suppliers competing with each other based on price and services is weak, almost nonexistent. Doctors and hospitals do not need to add convenient electronic information to their service provision because their payments will be the same either way. Indeed, most health insurers are mildly supportive of an improved HIT system—so long as they do not have to pay higher reimbursement rates for medical claims.