The issues around digitizing medical health records will be high cost, the difficulty of moving from legacy systems to new computer software, and privacy.
Change won't come easily despite the enormous benefits that will be reaped by patients, doctors, and government.
I have written many times about the importance of selecting the "right" personal physician. It took us four changes before we got it right.
It turns out that our personal physician successfully installed a new computerized system that is completely paperless. When we visit he enters all the information directly into a computer. Want to know the last time you had a chest X-ray and the result? Our doctor hits a couple of buttons and there is the information right at his finger tips.
A few months ago I was worried that my mother was getting pneumonia. I called the doctor and he worked us in in a couple of hours. After checking her out he was also worried. He sent us across the hall for a chest X-ray. By the time we walked back to his office he was viewing her X-ray and was able to tell us my mother was not suffering from pneumonia. However he was concerned with the results. He gave her a shot and prescribed a very strong antibiotic. No waiting a day or two for the results of the X-ray; and an, immediate diagnosis and treatment. In cases like this immediate treatment makes a big difference in the eventual outcome.
I cannot tell you how reassuring and uplifting the use of modern technology can be. It really gives you confidence that you are getting the best treatment available; and more importantly, a quick diagnosis that leads to immediate treatment means no worrying for days at a time while you wait for test results. In the future results will come back fast and the follow-up care will be more immediate. Have you ever sat around for a week wondering, what if?
My doctor proved that the transition to the digital age can be made. I am sure doctors will resist at first. Purchasing and installing the hardware and software will cut into their profit in the short term. And, they will need to learn how to use the technology and get comfortable using the new computer software.
Once they install an efficient computer system good things will happen. First, their productivity will be increased and they will be able to see patients on schedule. Second, it will allow them in cases like I described above to deliver immediate medical treatment and advice . In the past we would have made at least one additional visit to the doctors office and the treatment would have been delayed. Third, when necessary, it will allow doctors' to view recent medical tests online and do away with the need for faxing and delivery of these documents. This will bring additional costs benefits across the entire medical system and lead to major savings to insurers like Medicare. Less duplication and waste means lower costs.
By adopting modern day technology everyone will see lower costs, increased profits, and a more efficient use of time. Patients and caregivers will spend less time running back and forth to the doctor and the doctors' office will be running more efficiently. This will result in less time lost at work and less money spent on things like--gasoline.
By adopting modern day technology everyone will see lower costs, increased profits, and a more efficient use of time. Patients and caregivers will spend less time running back and forth to the doctor and the doctors' office will be running more efficiently. This will result in less time lost at work and less money spent on things like--gasoline.
All of this is a good thing.
Obama's big idea: Digital health records
President-elect wants to computerize the nation's health care records in five years. But the plan comes with a hefty price tag, and specialized labor is scarce.
By David Goldman
NEW YORK (CNNMoney.com) -- President-elect Barack Obama, as part of the effort to revive the economy, has proposed a massive effort to modernize health care by making all health records standardized and electronic.
Here's the audacious plan: Computerize all health records within five years. The quality of health care for all Americans gets a big boost, and costs decline.
Sounds good. But it won't be easy.
In fact, many hurdles stand in the way. Only about 8% of the nation's 5,000 hospitals and 17% of its 800,000 physicians currently use the kind of common computerized record-keeping systems that Obama envisions for the whole nation. And some experts say that serious concerns about patient privacy must be addressed first. Finally, the country suffers a dearth of skilled workers necessary to build and implement the necessary technology.
"The hard part of this is that we can't just drop a computer on every doctor's desk," said Dr. David Brailer, former National Coordinator for Health Information Technology, who served as President Bush'shealth information czar from 2004 to 2006. "Getting electronic records up and running is a very technical task."
It also won't come cheap. Independent studies from Harvard, RAND and the Commonwealth Fund have shown that such a plan could cost at least $75 billion to $100 billion over the ten years they think the hospitals would need to implement program.
That's a huge amount of money -- since the total cost of the stimulus plan is estimated to cost about $800 billion, the health care initiative would be one of the priciest parts to the plan.
The biggest cost will be paying and training the labor force needed to create the network. Luis Castillo, senior vice president of Siemens Healthcare, a company that designs health care technology, said the laborers will have the extremely difficult task of designing a a system that "thinks like a physician."
"Doctors cannot spend hours and hours learning a new system," said Castillo. "It needs to be a ubiquitous, 'anytime, anywhere' solution that has easily accessible data in a simple-to-use Web-based application."
But highly skilled health information technology professionals are as rare as they come, and many IT workers will need to be trained as health technology experts.
Early government estimates showed about 212,000 jobs could be created from this program, but Brailer said there simply aren't that many Americans who are qualified.
Furthermore, ensuring the privacy of patients' records in a nationalized computer network will be tricky. There are obvious concerns about hackers and system failures. And new online health record systems, such as Google Health are not currently subject to the Health Insurance Portability and Accountability Act, the national health privacy law.
"HIPAA was never intended for the digital age, because the laws never anticipated the emergence of Web-based records," said Brailer. "Congress can pass one of numerous policy proposals for change, it's just a question if they have the will to do that."
Jobs and savings for the future
The Obama transition operation declined a request to elaborate on Obama's proposal. The president-elect said Thursday in a speech on the economy thatthe benefits of a modernized national health record system go beyond just cost savings.
"This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests," said Obama. "It just won't save billions of dollars and thousands of jobs -- it will save lives by reducing the deadly but preventable medical errors that pervade our health care system," he added.
Still, compared to the $2 trillion a year that the industry spends, the$100 billion experts say it may cost to implement Obama's planis a drop in the bucket.
"We must reduce waste to become more efficient" said Brailer.
The savings of such a plan could be substantial. Brailer estimates that a fully computerized health record system could save the industry $200 billion to $300 billion a year.
That could ultimately slow the rapid rise of health care premiums, which have cut into Americans' paychecks. While wages are rising at a rate of around 3% a year, health care costs are growing at about three times that rate.
"Obama's support for electronic medical records is one of the key efforts of health reform that actually will deliver lower costs for hard-working American families," said Larry McNeely, a health care advocate at U.S. Public Interest Research Group. "Long-term savings can't happen unless we have 21st century health information technology."
Massachusetts has developed a plan to fully computerize records at its 14,000 physicians' offices by 2012 and its 63 hospitals by 2014. After a pilot program, the state legislature estimates it will cost about $340 million to build the statewide computer system, with a cost of about $2 million per hospital.
"[Obama's] timeframe is very ambitious, but there is a need to be able to track data on patients and talk across providers and health care systems," said Dr. JudyAnn Bigby, Secretary of Health and Human Services for Massachusetts. "The program will allow for greater patient safety."
Some say some of the hard work has begun. The Bush administration laid much of the groundwork for the program, leading to several pilot programs in a handful of states, as well as a standardization of medical records.
"The whole structure has already been developed," said Stephen Schoenbaum, executive director of The Commonwealth Fund's commission on a high performance health system. "It's feasible to at least make a lot of progress on this in the next five years."
Find this article at:
http://money.cnn.com/2009/01/12/technology/stimulus_health_care/?postversion=2009011204
Obama's big idea: Digital health records
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President-elect wants to computerize the nation's health care records in five years. But the plan comes with a hefty price tag, and specialized labor is scarce.
By David Goldman
NEW YORK (CNNMoney.com) -- President-elect Barack Obama, as part of the effort to revive the economy, has proposed a massive effort to modernize health care by making all health records standardized and electronic.
Here's the audacious plan: Computerize all health records within five years. The quality of health care for all Americans gets a big boost, and costs decline.
Sounds good. But it won't be easy.
In fact, many hurdles stand in the way. Only about 8% of the nation's 5,000 hospitals and 17% of its 800,000 physicians currently use the kind of common computerized record-keeping systems that Obama envisions for the whole nation. And some experts say that serious concerns about patient privacy must be addressed first. Finally, the country suffers a dearth of skilled workers necessary to build and implement the necessary technology.
"The hard part of this is that we can't just drop a computer on every doctor's desk," said Dr. David Brailer, former National Coordinator for Health Information Technology, who served as President Bush'shealth information czar from 2004 to 2006. "Getting electronic records up and running is a very technical task."
It also won't come cheap. Independent studies from Harvard, RAND and the Commonwealth Fund have shown that such a plan could cost at least $75 billion to $100 billion over the ten years they think the hospitals would need to implement program.
That's a huge amount of money -- since the total cost of the stimulus plan is estimated to cost about $800 billion, the health care initiative would be one of the priciest parts to the plan.
The biggest cost will be paying and training the labor force needed to create the network. Luis Castillo, senior vice president of Siemens Healthcare, a company that designs health care technology, said the laborers will have the extremely difficult task of designing a a system that "thinks like a physician."
"Doctors cannot spend hours and hours learning a new system," said Castillo. "It needs to be a ubiquitous, 'anytime, anywhere' solution that has easily accessible data in a simple-to-use Web-based application."
But highly skilled health information technology professionals are as rare as they come, and many IT workers will need to be trained as health technology experts.
Early government estimates showed about 212,000 jobs could be created from this program, but Brailer said there simply aren't that many Americans who are qualified.
Furthermore, ensuring the privacy of patients' records in a nationalized computer network will be tricky. There are obvious concerns about hackers and system failures. And new online health record systems, such as Google Health are not currently subject to the Health Insurance Portability and Accountability Act, the national health privacy law.
"HIPAA was never intended for the digital age, because the laws never anticipated the emergence of Web-based records," said Brailer. "Congress can pass one of numerous policy proposals for change, it's just a question if they have the will to do that."
Jobs and savings for the future
The Obama transition operation declined a request to elaborate on Obama's proposal. The president-elect said Thursday in a speech on the economy thatthe benefits of a modernized national health record system go beyond just cost savings.
"This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests," said Obama. "It just won't save billions of dollars and thousands of jobs -- it will save lives by reducing the deadly but preventable medical errors that pervade our health care system," he added.
Still, compared to the $2 trillion a year that the industry spends, the$100 billion experts say it may cost to implement Obama's planis a drop in the bucket.
"We must reduce waste to become more efficient" said Brailer.
The savings of such a plan could be substantial. Brailer estimates that a fully computerized health record system could save the industry $200 billion to $300 billion a year.
That could ultimately slow the rapid rise of health care premiums, which have cut into Americans' paychecks. While wages are rising at a rate of around 3% a year, health care costs are growing at about three times that rate.
"Obama's support for electronic medical records is one of the key efforts of health reform that actually will deliver lower costs for hard-working American families," said Larry McNeely, a health care advocate at U.S. Public Interest Research Group. "Long-term savings can't happen unless we have 21st century health information technology."
Massachusetts has developed a plan to fully computerize records at its 14,000 physicians' offices by 2012 and its 63 hospitals by 2014. After a pilot program, the state legislature estimates it will cost about $340 million to build the statewide computer system, with a cost of about $2 million per hospital.
"[Obama's] timeframe is very ambitious, but there is a need to be able to track data on patients and talk across providers and health care systems," said Dr. JudyAnn Bigby, Secretary of Health and Human Services for Massachusetts. "The program will allow for greater patient safety."
Some say some of the hard work has begun. The Bush administration laid much of the groundwork for the program, leading to several pilot programs in a handful of states, as well as a standardization of medical records.
"The whole structure has already been developed," said Stephen Schoenbaum, executive director of The Commonwealth Fund's commission on a high performance health system. "It's feasible to at least make a lot of progress on this in the next five years."
Find this article at:
http://money.cnn.com/2009/01/12/technology/stimulus_health_care/?postversion=2009011204
Obama's big idea: Digital health records
