“80% of hospitals embrace electronic records” USA Today 7/17/13.
These articles I find interesting, misleading and scary. When you read this you can hear our President or members of his staff talking about how shortly all our medical records will be electronic and transferable, everywhere and at any time. This is a good concept and worthy of exploring since it could speed up care and reduce errors or excessive tests. Having been in charge of several large computer conversion programs and having managed large staffs of computer experts, I will tell you this is not going to happen in most of our lifetimes!
The article, to be fair, says that hospitals “embrace” the concept of electronic records and have started to computerize their records. The federal government has provided over 300,000 health care organizations with over $15 billion to help make this happen. Sounds like a lot of money but it is not. A simple average is $50,000 per health care provider. In the world of computer systems projects, this is literally a spit in the old medical bucket.
At both of the large public companies where I was the CFO, we undertook huge computer hardware and software projects. At USG Corporation, we installed, with the help of the consulting firm Accenture, a new centralized, customer order entry system. This involved combining over 20 existing order centers, which used similar manual and computerized procedures, into one, brand new, custom designed software system. This took about a year, involved several hundred part and full time people and cost tens of millions of dollars (today it could run $100 million.) That was one system conversion for one company.
But the medical world is, in many ways, much more complex. As an older guy, I get to visit several doctors at my large, Chicago hospital. My internist and one other separate specialist, are in private practice and are not part of the hospital. Each of these firms have their own, unique computer systems. These independent medical providers do not want to use the hospital’s system or share their confidential patient records. Another specialist is part of the hospital and uses their system. I have a separate account with each doctor and several sets of separate records. When I occasionally get a test done in Florida and want it sent to Chicago, it is usually faxed as the medical world has been very slow to adopt email.
The world of medicine consists of many separate providers. Some are parts of hospital groups but most are not. When I chat with the staff in any of my doctors’ offices and ask them about centralized, transferable medical records they politely smile and would tell you that do not know how or when it will ever happen.
I know that business people are not very popular in Washington these days, but we could use some people who have actually done something along these lines if we are ever to hope to create one system of electronic medical records. The other interesting quote in this article was that today over 190 million prescriptions are filled electronically. Do you think it was because all the doctors wanted to quit scribbling these things out? No, it is because the major insurance providers like Aetna and Caremark created o- line systems that doctors could use. Those companies are not part of the federal government. Innovation in the medical world of electronic records will not come from our government doling out subsidies to every health care firm, it will come from those dreadful business firms who approach this as a business opportunity first and make it worthwhile and profitable for the medical world to follow.
Systems and procedures are a fascinating subject that we will cover more in my book, The Business Zoo!