How IT can help hospitals – or not

Really interesting take on an academic study that attempted to quantify how much hospitals saved by implementing IT systems. The answer: nothing. From the Fiscal Times:

• Despite the widely accepted assumption that healthcare IT reduces costs, improves efficiency and enhances quality of care, researchers found that the use of IT actually has resulted in higher costs, higher levels of nurse staffing and higher patient complications, in the short term.
• Hospitals using IT systems experienced lower death rates for certain conditions, most likely because the electronic medical records systems helped cut down on medical errors.
• Many hospitals might not be seeing benefits from IT because they have only partially implemented the new systems and because they haven’t improved flawed and inefficient processes.
• Hospitals shouldn’t expect any major short-term benefits from electronic medical records systems. But in the long term, they can expect to see improvements in patient safety and quality of care before they experience any major cost savings.

To me this was the real eye-opener:

The positive effects of electronic records systems also can be blocked if hospitals fail to improve their processes. If a process is flawed before the system is computerized, it will remain flawed afterward. They are just computerizing inefficient processes.

Anyone who has been around a major IT upgrade knows that part of the upgrade is a re-engineering of the process. It’s mind-boggling to me that an industry as big as hospitals doesn’t understand that. In my darker moments, I fear that the health care system has fallen so far behind in using non-medical technology and embracing process changes that it will be decades before it operates as efficiently as the DMV.

I’m probably super-sensitive to this today because my daughter’s orthodontist asked me to send them a fax of a Xerox.

[Rant] A fax? A Xerox? Who still has a fax machine? Who still depends on Xerox copies? What year is this? Heard of email? PDF? [/Rant]

But without re-engineering, you really don’t gain a lot of efficiency. And you have to be patient as people get used to the new process.

A good example of process re-engineering is how I handle the family checkbook now.

The old process:

1. Gather up this month’s bills.
2. Write check.
3. Post entry.
4. Address envelope.
5. Seal.
6. Apply stamp.
7. Repeat 2-7 for every check.

This would take about 90 minutes.

The new process:

1. Gather up this month’s bills.
2. Go online.
3. Pay bills.
4. Post entries in checkbook.
5. Post entries in Quicken.

This takes about 10 minutes and saves stamps. But even so, the new process has not been completely reengineered. I really don’t have to post entries in the checkbook. The online bank has that information. And I don’t have to post to Quicken. A download from the bank could do that.

But I’m still not completely comfortable with the new process, so I cling to some vestiges of the old one. Eventually, I will completely embrace the new process, but I just have to get a bit more comfortable with it.

Meanwhile, I still need to handle some checks the old way. Interesting, one of those is to my health insurer.