Information Technology and Healthcare

This week, my attention has been drawn to information technology.   I just read an article in the AMA News detailing how electronic medical records are distracting physicians from patient care.  I agree – an overhaul is needed. In the past week, the web based Electronic Medical Records (EMR) system I use (which I generally find useful and cost effective compared to paper charts and to my prior EMR) was intermittently slow or unavailable in no particular pattern. I was  unable to use it to care for patients after a “routine maintenance”.  Being repeatedly disconnected in the middle of documentation has not made me a better doctor for my patients.

By contrast, Apple unveiled their new iPhones, the Apple Watch, Apple Pay and iOS 8.  A notable enhancement in each of these new devices and in the operating system is the upgraded health and fitness related applications.  I look forward to using these devices to make life better.

There is an obvious contrast here.

On the one hand, the government has driven adoption of EMR technology by baiting physicians with financial incentives and bullying them with penalties.  The resulting focus on satisfying the long list of requirements for “meaningful” use has resulted in software that dissatisfies its users and impedes many aspects of patient care.  The extra effort I must extend to qualify for the government’s incentive will be greater than the reward.  I have decided that I’m not going to fall for it.  Instead, I’m going to focus on the reason I’m a doctor:  Help my patients be healthier.

EMR allows data to be more easily mined, but if the users are inputting the equivalent of “garbage”, what can we expect to learn from the output?  I have heard directly from the support staff for my EMR that resources to improve the usefulness of their software have been diverted to satisfy government requirements for “meaningful use” and certification.  Users of EMR’s and the patients we serve are not the primary customers.

On the other hand, Apple develops devices and software that people wait in line overnight to be among the first to acquire.  The Apple Watch will be able to measure heart rate through a sensor on the back as it interfaces with your skin!  Accelerometers in the iPhone will be able to document your movements and present them to you in ways that will rival the functionality of currently available personal fitness monitors and let you see the results of your efforts.  Other developers, including Google and Microsoft, are working on similar products.

Which approach will create the greater good?  Technology should improve our lives and makes us more productive and happy.  I would put my trust in Apple CEO Tim Cook to provide that long before I would trust the Secretary of Health and Human Services.