With Halloween upon us we turn our attention to ghouls, ghosts and ghastliness. One example is all the bad press over the zombie of the medtech industry: healthcare IT, especially electronic health records (EHRs).
First, a scathing article in Mother Jones describes the dirty secret of EHRs in America: systems from rival companies cannot communicate with each other. This leaves the healthcare system fragmented and just as inefficient as it was before the federal government encouraged hospitals to digitize in 2009. The $28 billion public dollars spent for this initiative so far are widely considered not to have resulted in the imagined savings.
Second, a review of the new book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age in NEJM has resonated strongly with US physicians: EHRs have disrupted medical practice negatively. The piece describes how expensive IT systems have bankrupted small practices, locked facilities into abusive contracts, increased the workload of physicians to fill out tedious and meaningless forms, and generally ruined the doctor-patient relationship.
With all this in mind I can’t help but think of healthcare IT as a zombie: it’s a soulless, relentless, consuming force that just can’t be stopped. It has all the characteristics of zombies: systems have been feasting on the time and resources of healthcare staff and facilities. These zombies are difficult to combat since patient data might be locked in a proprietary encryption, meaning that hospitals are reluctant to switch vendors. As a result, many facilities are using systems that are well passed their due date. As these IT systems become outdated, it clashes with newer capital purchases, leaving facilities an unholy hodgepodge of multiple computers and monitors that only work with specific diagnostic equipment. Indeed, the undead live.
However, this zombie apocalypse may have a happy ending. In mid-October there was legislation introduced to the Senate that aims to ensure that health IT is more interoperable and responsive to the needs of healthcare facilities. Facilities will certainly enjoy the ability to rate vendors, it’ll be akin to communicating with disparate human survivors over an improvised radio. Fines paid by vendors if they do not report on their product performance will help clear away the worst zombie culprits. Hopefully this program will act like anti-zombie serum and bring order.
In the meantime, keep running.