Ms. Faulkner understands why it’s taken much longer for the health care industry than, say, banks and airlines to move to electronic data. In banking, the types of data are much more limited and known, she says. In health care, by contrast, data is constantly changing based on information from doctors, nurses, patients and others. New discoveries, protocols and government requirements add even more complexity.
Full article on electronic medical records.
Fantasy baseball managers have far more data to evaluate players for their teams than patients and referring doctors have in matter affecting life, death and disability.
George Shultz, Arnold Milstein, and Robert Krughoff, Wall Street Journal.
This is Kevin Outterson at The Incidental Economist:
In October 2013, the US health care system will undergo a dramatic coding change as we transition from ICD-9 to ICD-10….
[H]ospital inpatient procedural codes will grow from 3,800 to 72,000; physician diagnostic codes from 14,000 to 69,000. Implementation costs for a three physician practice may average $83,000, with the per-doctor implementation cost dropping to $28,500 in a ten doctor practice. (see Harris Meyer’s reporting in May 2011 Health Affairs). No one reimburses providers for these transition costs.
The National Programme for IT in the National Health Service was launched in 2002 with a 2010 goal of providing every NHS patient with his very own electronic medical record. Yet in its most recent report, the British National Audit Office states that the Department of Health there has been a:
steady reduction in value delivered not matched by a reduction in costs. On this basis we conclude that the £2.7 billion spent on care records systems so far does not represent value for money, and we do not find grounds for confidence that the remaining planned spend of £4.3 billion will be different.
As in the U.S., the system was sold with claims that it would improve services and the quality of care. In fact, many of the proposed applications, like internet appointment scheduling, electronic prescribing, computerized order entry in hospitals, and a secure organizational broadband communications network are already in use, without government subsidy, in the U.S.
Maine’s high risk pool has only 14 people in it. HT to Yglesias
Dodd-Frank regulation maze. (neat graphic) (HT to David Henderson)
Florida doctors are refusing to treat obese patients.
Under-doctored? Rural Americans get more surgeries than city folks.
Report: Electronic medical records are vulnerable. But surely you already knew that.
AMA report: Standardizing EMRs would “stifle innovation.” But surely you already knew that as well.
Study after study suggests that mandatory electronic medical records will raise health care costs without generating significant benefits. Despite this, ObamaCare requires that individual health information be posted to insecure databases in order to facilitate widespread access to extensive detail about every individual’s health. When the person involved is an important figure in a publicly traded company, public disclosure of previously private health information can move markets. Access to that information in advance of a public announcement can create tidy trading profits.
To see how much money even relatively unsophisticated insider trading schemes can create, consider the case of Cheng Yi Liang, an FDA chemist recently arrested for insider trading on FDA drug approval information. Mr. Liang had access to DARRTS, a confidential FDA database that manages, tracks, and reports on the progress of new drug applications. The FDA usually delays the public announcement of its decision for 24 hours after it informs a new drug applicant of its decision.
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About 20 percent of U.S. hospitals and 30 percent of office-based primary-care doctors — about 46,000 practitioners — had adopted a basic electronic record in 2010, according to government statistics. So why is that?
Such systems are hard to use and difficult to maintain. They disrupt clinical practice. They don’t increase efficiency and often don’t pay for themselves. They disrupt the doctor-patient interaction. And they are very, very expensive.
I fear that the current incentives — simple monetary carrots and sticks — that the government is trying in order to increase the use of information technology in the practice of medicine won’t work. Just as we have a patchwork insurance system in the US, we have a patchwork IT system as well. There are relatively few standards, tons of companies, and lots of failures. It costs too much, it doesn’t work as well as you’d think, and there are way too many avoidable errors.
This is by Aaron Carroll, an advocate of EMRs.
The percentage of doctors saying that the financial benefits of electronic records outweigh the costs fell to 64% from 71% last year. And the percentage saying the patient-care benefits justified the financial investment fell to 68% from 73%. This year’s survey also found doctors were less likely to agree that electronic records can help reduce medical errors, improve efficiency and lower costs. And a greater proportion of physicians said electronic records slow them down and don’t achieve a measurable financial impact.
Full article on doctors’ views of electronic medical records.
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