At the same time, they’re trying to determine how to best connect, collect, and care for all of this data and relying on their IT teams and/or managed service providers (or both) to deliver the solutions they need.. As you might imagine, this is very private, extremely personal, very sensitive data being digitally collected and kept. Arguably, security and compliance have to be one of the top priorities in digital health. Personally, I think these advances in medical tech are incredible, but what becomes clear, as with any other industry, is that all of these advancements, along with the astounding amount of patient and potential medical research data collected, is meaningless if it can’t be adequately protected.
The High Cost of Medical Technology
And therein lies the Catch-22 of modern healthcare. Many smaller health care facilities and independent physicians are finding that technology and IT headaches are actually imposing a heavy financial burden, forcing them to consider giving up their independent status, or even go back to old fashioned paper records.
This developing situation in the medical sector raises an interesting question for IT pros, managed service providers, Chief Information Officers, and policymakers. We know that the number of independent physicians in the U.S. is falling year by year. In fact, the nation’s doctor shortage of could hit 90,000 by 2025 as the U.S. population grows. What if the costs associated with digital health systems are just too high and the compliance rules too complex and punitive? What happens if independent physicians just can’t afford to maintain the safety and security of the new systems? In other words, is there a danger that the technology could threaten to kill off the independent physician in our health system?
Electronic Healthcare Records
As is the case in many countries across the world, U.S. policymakers are working to create a standardized health record system designed to improve efficiency and the quality of outcomes while also reducing costs. Although electronic medical records have been around in America for some time, their use was formally adopted as a critical national goal following the introduction of the Health Information Technology for Economic and Clinical Health Act (HITECH) in 2009.
The result was the Electronic Health Record (EHR), a digitized health information system designed with the aim of creating an official record that can be shared across multiple health agencies. Incentive programs have been created to encourage health professionals to not only adopt certified EHR technology, but also to demonstrate that they are putting it to “Meaningful Use”.
But as is often the case, it’s not running as smoothly as the original architects of the legislation intended, with several recent stories highlighting both technical and administrative difficulties.
Are EHR Vendors the Problem, or the Cure?
SearchhealthIT reported that two independent physicians in North Carolina suffered IT emergencies, experiencing EHR server crashes that resulted in significant disruptions to patient care. The physicians both said that the IT failures, and the resultant loss of patient health information, were due to their EHR vendors having poor backup systems and flawed disaster recovery plans. Both now say that their confidence in IT has been impacted and suggested that they may return to paper records to lower costs and the reduce worries about reliance on IT.
According to a report from the America Academy of Family Physicians (AAFP), burdensome and inflexible “meaningful use” audits were making life difficult for some family doctors. The process was taking doctors away from patient care and may indeed be acting as a disincentive to moving forward with EHR according to the AAFP.
The Wall Street Journal reported that the Office of the National Coordinator for Health Information Technology had criticized some EHR vendors for frustrating the push to implement the EHR program. According to the ONC report to Congress, it had received several complaints that some health IT developers and providers were engaging in “information blocking” which was interfering with “the exchange or use of electronic health information.”
The Senate Health, Education, Labor and Pensions Committee suggested that the meaningful use program, despite an outlay of $30 billion, had failed to deliver on its promises to “improve care, improve coordination and reduce costs.” iHealthBeat reported that the program had come under attack from physicians and stakeholders alike. Statements from two witnesses in particular highlighted the complex nature of the situation and the conflicting forces at play in the implementation of EHR.
- Julia Adler-Milstein, an assistant professor at the University of Michigan, said that it is high costs and competition between health care providers that are the main barriers to interoperability, not technology.
- Angela Kennedy, head of the Department of Health Informatics and Information Management at Louisiana Tech University Louisiana Tech University, bemoans the lack of information governance in the system saying, “If we continue with a narrow focus on technology and without a focus on information governance processes and principles, the U.S. will continue to experience daunting challenges related to health information exchange and sharing, patient identification and privacy and security.”
It’s against this confused background that our medical practitioners must decide how best to proceed with the implementation of technology into their day-to-day practices and their record keeping.
Some it seems are choosing the comfort of operating within a partnership with a larger health operator such as a hospital, an option that allows access to technology, systems, and support that would otherwise be unaffordable. Others, though, might be deterred by the lack of flexibility and the loss of control that such an arrangement might entail. They might just be tempted to try to opt out of EHR and the technology altogether, surely not a sustainable option in the long-term as the health system becomes ever more digitized.
The IT industry is facing a unique challenge in the highly regulated and cost sensitive health care sector. Many aspects of EHR, such as the decisions of policy makers and the commercial pressures on health care providers, are outside the control of IT professionals – yet the foundation of the system though will always be the technology itself.
The question for IT leaders, managed service providers, and Chief Information Officers becomes, what’s going to happen if no one can afford your services? What can you do as an industry to ensure high security and reliability at a manageable cost for the small to medium sized operator? Do you need to come up with new technology so that the exciting digital health opportunities and incredible research and diagnostic possibilities that come from this Big Health Data can be accessed and utilized by all healthcare providers? What can IT do to help administrators and commercial providers come up with a way to develop an integrated and cost effective system?
The future of our independent physicians and indeed the smooth running of our health care system could depend on the IT sector coming up with the right answers to the above questions. If you are involved in health IT, I would love to hear about your experiences and your views on the future direction of technology use in our health sector.
Other resources on this topic:
Hospitals offering software, other resources to independent physicians
The Brave New World of Modern Medicine: Healthcare Meets the Digital Age
Doctors Beware: the Electronic Health Records Debacle May Get Much Worse
This post was brought to you by IBM for MSPs and opinions are my own. To read more on this topic, visit IBM’s PivotPoint. Dedicated to providing valuable insight from industry thought leaders, PivotPoint offers expertise to help you develop, differentiate and scale your business.