Link: Mining Clinical Data
Optimistic predictions by RAND Corporation in 2005 encouraged adoption of electronic medical records (EMRs) and encouraged the federal government to "give billions of dollars in financial incentives to hospitals and doctors that put the systems in place." Does HITECH Meaningful Use come to mind?
Interestingly, RAND’s 2005 report was paid for by a group of companies, including General Electric and Cerner Corporation, who profited from widespread report dissimenation describing the value of technology. It is no surprise that "Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005."
"The 2005 report predicted that widespread use of electronic records could save the United States health care system at least $81 billion a year, a figure RAND now says was overstated. However, the study was widely praised within the technology industry and helped persuade Congress and the Obama administration to authorize billions of dollars in federal stimulus money in 2009 to help hospitals and doctors pay for the installation of electronic records systems (EMR)."
No doubt the savings was overstated and the report (sponsored and paid for by those who could benefit) causes healthy scepticism in its results. Other reasons cited for increased costs in the report include:
- "Sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and
- The failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT."
Although I agree there has been sluggish adoption, I disagree that we MUST reengineer care processes to reap the benefits.
EMR systems should be flexible enough to adapt to the workflow of users - even if minimal changes to the workflow are necessary. The ability to analyze the system and compare features to the clinical workflow (for example) will result in less risky patient care. Re-engineering the entire clinical workflow to adapt to the system is permeated with risk and could be a potential source for unintended patient harm. This is the "Geek Nurse" in me talking now..