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July 9, 2019 by Dr. Kyle Varner in Solutions
Do you remember when you paid for everything in dollar bills and checks? I certainly do, but we don’t live in that world anymore.
Nowadays, all it takes is a tap of a card on a little box to make a payment. It’s quicker, less cumbersome and more efficient.
We don’t have to feel as vulnerable when we walk down the street. All it takes is one person to pull out a gun and demand your wallet, and your money is gone…
Despite the fact it’s a less charming form of payment and opens up the doors to cybercrime and hacking, I’d wager most people think this is a step forward.
But the transition from paper to computers in health care is a much less optimistic story…
We used to have our medical records on paper, and as you can imagine, the handwriting of the average doctor is not very good.
This caused a lot of medical error, which is one of the leading causes of death in the US.
So we transitioned to electronic medical records (EMRs).
The problem is when you have all your eggs in one basket, and there are bad incentives, trouble brews…
Way back in 2012, a certain Annette Monachelli had what felt like a migraine, but she suspected it was something more.
She visited her doctor, but to no avail, two months later she was dead from a brain aneurysm.
Naturally, her widower took this into the legal sphere, and what transpired was much bigger than a simple case of medical malpractice.
It turns out, the doctor did, in fact, want to rule out an aneurysm, and sent a request for a head scan. But the request never made it through…
The problem was bad technology, and it turned out throughout the case that it was disturbingly common.
Missing prescription drugs, mismatched physician notes for patients, old drugs listed as new, you name it every problem under the sun was there…
Simply put, while EMRs are well-intentioned, the application is not. The software is bad, really bad.
Owen Foster, the assistant U.S. attorney with the District of Vermont who defended the government in the case above said, “It would be like if I was driving with the radio on and the windshield wipers going and when I hit the turn signal, the brakes suddenly didn’t work.”
Moreover, the people who sell the software and the hospitals have a few good few tricks up their sleeves to avoid blame and silence critics…
So how did this come about? The government messed it up, of course. It started out with good intentions, as always–President Obama signed a law to accelerate the digitization of medicine and sunk $36 billion into it.
But what we got wasn’t a technological revolution, it was a group of patchy and disconnected digital islands that didn’t talk to each other. That’s no good for necessary accurate medical communication, and the government forced it through.
This isn’t a case where doctors and patients wanted to improve medical efficiency, oh no. This is where the government waved around $36 billion and the corporations ran to it like bees to a honeypot.
The people are the top of giant health systems and tech companies wanted that sweet government money at any cost.
Aside for a practically guaranteed government contract, if you’re in the EMR game, you’re more likely to be hooked up with better insurance partnerships and government protection.
And who cares if it kills a few patients, right?
The EMR scandal is just one example of bad incentives in health care. We don’t have a system where companies are rewarded when they do a good job and please customers.
No, instead we have a system where you get ahead when you’re close to government programs, even if they’re awful.
We have a system where we make communication difficult in order to beat our competitors, even if it’s worse for the patient.
We could theoretically change the incentives, but it would require a free market with robust competition. Then, hospitals would seek out EMR systems that facilitate good care–because that would impact their bottom line.
I’ve never seen an EMR that is an improvement over pen and paper. Every EMR I have ever worked with has been an impediment to patient care, and many doctors feel the same.
It’s not just because health care is expensive that American patients suffer. No, now we have bad technology too. It is because our health care is held captive by third-party payers who have no interest in getting you good care.
Let’s kick third parties and the government out of the doctor-patient relationship and stop this deadly EHR nonsense. Only then will we gain some sanity into how we structure our healthcare system.
This information is intended to help readers be more informed about their health options when speaking with a professional, but it should not be used alone to diagnose, treat, prevent or cure any disease or condition. Be sure to speak to a qualified doctor before taking any action to make sure that your choices reflect your actual health situation.