Politics, money and the money of politics can ruin anything. In my life and work, they’ve ruined technology.
Clearly, I’m pro-tech. Of course, that’s only for tech that is good, that makes my life easier, that creates value, efficiency and quality. Tech that does not do this is bad and should be thrown away, or better yet, never bought in the first place.
It is part of the politics of the time that Electronic Medical Records (EMRs) or Electronic Health Records (EHRs) are a panacea for all the problems in modern healthcare. Once everyone is using them, efficiency will increase, errors will decrease, massive amounts of money will be saved, the lion will lay down with the lamb and pink unicorns will have rainbow farts.
Except, the current EMRs are so horribly designed and beholden to some many asinine governmental requirements that the exact opposite is occurring. (I know, pink zombies with sulfur farts—it’s terrifying.) The the immense amount of pressure from the payers in medicine (that’s the insurance companies and the government, not the patients) to implement them is resulting is massive amounts of wasted money.
Here’s just one example, from Throckmorton:
It has decreased the numbers patients that can be see in a clinic by 30%. Even with that reduction, the clinic runs an extra hour and half longer. The actual time of patient contact, defined as listening, examining, and answering questions has been decreased by 50%.. We have had to hire 2 new assistants for every three doctors. We are told that it would improve our coding and because of this it would be cost neutral. As of today, it has decreased productivity and only added to overhead for a cost to the practice of 112k per physician.
This reminded me of a quote from Steve Jobs in Wired from 1996 regarding education that I think is perfectly applicable to the situation here as many of the same problems in medicine and education are similar:
I used to think that technology could help education. I’ve probably spearheaded giving away more computer equipment to schools than anybody else on the planet. But I’ve had to come to the inevitable conclusion that the problem is not one that technology can hope to solve. What’s wrong with education cannot be fixed with technology. No amount of technology will make a dent.
It’s a political problem. The problems are sociopolitical. The problems are unions. You plot the growth of the NEA [National Education Association] and the dropping of SAT scores, and they’re inversely proportional. The problems are unions in the schools. The problem is bureaucracy.
The problems in medicine are because powerful bureaucracies continue to create mountains of red-tape and mandates purporting to fix problems while only making them worse.