Yes, you probably know about this already but it is still worthwhile to thank Stephen Soumerai and his colleague Ross Koppel for their recent piece in the Wall Street Journal entitled "A Major Glitch for Digitized Health-Care Records."
In case you missed it, the authors trash the idea that electronic health records (EHRs) lead to increased efficiency. It took two accomplished scientists to make the case with data: The math simply does not add up.
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Full disclosure requires mention of the fact that Steve Soumerai and I worked on a quality improvement project in the mid 1990s and, much to our surprise, we found that the use of key opinion leaders did not impact care as much as we anticipated.
Steve is data driven. In the WSJ article he and Dr. Koppel characterize themselves as "applied researchers and evaluators." Indeed, that is the case.
As I hinted recently, we are faced with contorted logic that states: If "A" sounds good, it must be good, so we should do "A." Forget waiting for a study that proves "A" leads to "B," as in cost savings, improved efficiency, and better patient care. In a data-driven profession such as medicine, it’s rather shocking that this "A" is "A" logic won out. But not really, since politics and business intervened, at great cost to the health care system. As the authors point out, EHR adoption occurred despite a lack of standards and coordination. Rather, we witness a strange situation in which "government agencies ... serve as health IT boosters."
As an aside, I wonder, how many of those boosters no longer work for the U.S. government but instead consult for the IT industry?
In any event, I do not intend to convey a message denying the possibility that at some point, in a galaxy far, far away, in a health care system that is smaller, and where the incentives are more noble, EHR can work.
Or that in 10 years, and after many more billions are spent, we can find our way into a more user friendly system.
But until that point is reached, EHR has outwitted us. May the force be with you.