Health Care and IT: The Long Road to Wellness

“The development of our information processing industry is basically governed by longer term super-cycles… Analyses of what computational environments will facilitate can be mind-boggling. To offer just one example, health care delivery will be revolutionized by 1990, with most large metropolitan areas having implemented vertically-integrated health facilities coordinated by computer… [including] physicians’ offices, neighborhood health care centers, hospitals, university medical centers, nursing homes, rehabilitation centers and home health care”–Gideon Gartner, 1978

“Health care lags behind other industries in adopting information technology by as much as 10–15 years… In 2020, a forecast of widespread use of computers in health care within 15 years might finally be valid”–Peter Goldschmidt, 2005

“As Medicare chief, [Dr. Donald M. Berwick] has pushed doctors and hospitals to adopt electronic health records, merge their operations and coordinate care to eliminate medical errors that kill thousands of patients each year. If his estimate is right, Medicare and Medicaid could save $150 billion to $250 billion a year by eliminating waste, which he defines as ‘activities that don’t have any value.’”–Robert Pear, “Health Official Takes Parting Shot at ‘Waste’,” The New Work Times, December 3, 2011

“The controversy and contradictions started when Thomas Eric Duncan first was admitted to the emergency department at Texas Health Presbyterian Hospital Dallas Sept. 25. He told his nurse he had been in Africa prior to his arrival in the U.S. The information, THR officials say, was entered into the EHR, but the information somehow did not reach the appropriate clinicians. Duncan was then discharged from the ER that day, only to return to the hospital’s ER four days later, where he was then diagnosed with the Ebola virus. THR declined to comment further. The chain of events has sparked public debate amongst clinicians and IT professionals over whose mistake caused the failure to communicate Duncan’s critical travel history to physicians.”–Erin McCann, HealthcareIT News, October 6, 2014

“A 2013 RAND survey of physicians found mixed reactions to electronic health record systems, including widespread dissatisfaction. Many respondents cited poor usability, time-consuming data entry, needless alerts and poor work flows…  Even in preventing medical mistakes — a central rationale for computerization — technology has let us down. A recent study of more than one million medication errors reported to a national database between 2003 and 2010 found that 6 percent were related to the computerized prescribing system… The unanticipated consequences of health information technology are of particular interest today. In the past five years about $30 billion of federal incentive payments have succeeded in rapidly raising the adoption rate of electronic health records. This computerization of health care has been like a car whose spinning tires have finally gained purchase. We were so accustomed to staying still that we were utterly unprepared for that first lurch forward.”–Robert M. Wachter, The New York Times, March 22, 2015