A Management and Information Perspective on Healthcare - A Nation of Luddites

Why do you put up with this? 

You would long ago have cleaned up such an inefficient process in your company. Indeed, if your company insisted on operating this way, it would go under. You have brought technology into your professional and personal life to make you aware and efficient. And yet when it comes to your health, perhaps even your life, you must submit yourself to an antiquated and dangerous paper “system.”

Oh, we are quite innovative when it comes to medical discoveries. American-born scientists working in the United States have won 12 Nobel Prizes in medicine over the past decade. Three more have gone to foreign-born scientists working in the United States. By comparison, researchers outside of the U.S. have earned just seven.

But when it comes to using technology to build a business model for health care delivery, we are Luddites. In recent years U.S. health services have ranked 38th among 53 industries in business technology investment per worker. Health services spent less than one tenth what banks and other industries spent. That’s why the afternoon visit to the doctor we imagined for you was so disjointed.

This is not about your inconvenience. Various studies have yielded this alarming picture:

•    Every year medical errors cause 98,000 deaths (some studies suggest the number is twice that) and one million injuries. This is not a statistic. This is a national health emergency. And a scandal.

•    Medical errors kill more people each year than breast cancer, AIDS, or motor vehicle accidents.

•    Little more than half of patients receive the known best practices in care.

•    Less than half of doctors in large practices provide the recommended care for patients with chronic diseases.

•    Thirty to forty percent of the money we spend on health care – more than half a trillion dollars a year – is spent on costs associated with “overuse, under-use, misuse, duplication, system failures, unnecessary repetition, poor communication and inefficiency.”

•    One-fifth of medical errors are due to the lack of immediate access to patient information.

•    Eighty percent of medical errors were initiated by miscommunication, including missed communication between physicians, misinformation in medical records, mishandling of patient requests and messages, inaccessible records, mislabeled specimens, mis-filed or missing charts, and inadequate reminder systems.

•    Three out of every 10 tests are reordered because results cannot be found. Patient charts cannot be found on 30 percent of visits.

•    As much as $300 billion is spent each year on health care that does not improve patient outcomes – treatment that is unnecessary, inappropriate, inefficient, or ineffective.