There’s a flood of interesting news in the Health IT world. Each item deserves its own extended entry. Hopefully someday …
A recent study suggests that electronic health records don’t improve ambulatory health care – at least not unless they’re designed to take advantage of the things IT can do better than paper records can. As one of the study’s leaders, Dr. Jeffrey Linder, observed:
“There’s nothing magical about electronic health records. You need to have tools in place that take advantage of technology to show improvements in quality. You need to do additional work instead of just turning on the computer.”
EHRs must be joined to other knowledge-driven technology in order to enhance medical care. First, however, we need to catch up with Europe. Primary care doctors there have better access to IT than do their counterparts in North America.
A pilot project at Kaiser Permanente indicates that linking doctors and patients with web-based messaging reduces the number of office visits. While project leaders expected younger, more tech-savvy enrollees to be the primary users, they were surprised to discover that older patients were enthusiastic users of the system. Their health needs, especially regarding chronic care, led them to make the most use of messaging. That’s good news for a country with an aging population.
Now the nation’s economic model has to catch up with the technology. Reducing office visits is fine for Kaiser, where doctors are on salary. Fee-for-service medicine will be a hostile environment for messaging as long as doctors are giving up their time to message and losing income in return. As I’ve said for a long time, insurers will need to come up with a fee schedule for online consultation – a nominal fee of, say $5 with no patient copay – in order for programs like this to succeed.
Technology With a Human Touch
Dr. Thomas Lee has written an interesting piece about the human/technology interface and its relevance to health IT. We’re of like mind. IT won’t change or enhance human behavior in the health care system (using “system” in the global, socio-economic sense) until its easier to use.
Speaking of which, I thought I had weathered the iPhone craze without sparking my own techno-lust. But I saw one at a friend’s house this weekend. I’m trying to fight the phenomenon of craving that it triggered.
And speaking of health as a system – a dynamic organization with inputs, outputs, and behaviors that are observable, predictable, and changeable – there’s an exciting (to me, anyway) special edition of Health Affairs on“Rapid Learning”: using information from current and future electronic sources to monitor the changing epidemiological and behavior picture in order to respond rapidly to changing patterns of disease and treatment.
I hope to write more about this in the future. In a related effort, the DHS recently joined with bloggers from across the political spectrum in a very smart attempt to mobilize blogs and other web-based resources to help in case a pandemic strikes. Their first effort was Pandemic Flu Awareness Week. Hopefully there will be more such enlightened efforts in the future.
And it’s nice to be able to praise the Feds for a change.