Why don’t connected healthcare information systems work?

In a perfect world, connected healthcare information systems would be easy to use, offer doctors a way to effectively communicate with their patients without any barriers or restrictions and give patients a secured means of keeping track of their electronic medial records (EMR).  Today’s healthcare information system doesn’t do this.  

According to last month’s New England Journal of Medicine, 17% of U.S. physicians use some kind of electronic medical records system and only 9% of U.S. hospitals are adopting EMRs. What’s the holdup?

Some say it’s a case of misalignment of incentives. At this week’s MIT Sloan CIO Symposium, Dr. John Halamka, CIO of Harvard Medical School, talked about how implementing connected healthcare information systems comes at a high price in terms of cost and productivity to doctors and medical facilities, with little return on their investment. Halamka talked about how doctors are presented with this great new technology for electronic health records. But the doctors initially have to put their own money up to fund the technology investment. They then see an immediate loss in productivity due to the setup time and management of the system. Finally – their staff ends up quitting or complaining about all the extra work involved in the new process. What are the incentives to this? Extra hours, lack of productivity and no additional compensation. And how is that supposed to improve my healthcare experience?

Or maybe it’s a workflow issue that’s holding up the progress of connected healthcare information systems. Fellow panelist Gregory Veltri, CIO of Denver Health and Hospital, blamed the lack of progress on workflow. Veltri gave a great example of his CEO telling him, ”Nurses chart today the same way they did 30 years ago. You need to fix that.” This was a wake-up call for Veltri, who realized that doctors and medical facilities have a major workflow issue. They have been using the same systems and workflow processes for years and literally haven’t had the time to make changes.

Could the holdup be blamed on the technology? Does the technology behind connected healthcare information systems do a good enough job in meeting the needs of doctors, patients and insurance carriers? Connected healthcare information systems are very complex and involve doctors constantly codifying data for flows, reminders and alerts. Most doctors don’t think in terms of codes. Moreover, a lack of standards means the system your primary care doctor adopts might not be the same as the one a specialist or hospital has, making your record unusable by anyone but the facility that created it.

The goal of connected healthcare information systems should be “to push the right data to the right provider at the right time,” said Veltri. I’m not sure about you, but I’d rather have my doctor use a system that will allow him to spend more time figuring out my diagnosis, not just the right codes to enter.