Thursday, August 30, 2012

Three reasons why information technology won't save health care

Between rising health care costs, increases in chronic illnesses, an aging population, and the complexity of health care reform, the US healthcare system is facing an onslaught of challenges in the coming years.  In particular, the fragmentation of health care services is a particularly strong challenge to the system as people are living longer while living with more chronic conditions that require some level of monitoring.  On top of this, administrative costs make up at least 7% to 14% of health care spending.

Some argue that administration is the problem, and that it's things like paperwork that clog up the system and make it inefficient.  Leslie Ziegler asks "Can designers and developers save health care?"  and suggests that what we're really dealing with is a design problem. She recommends that entrepreneurs focus on creating better user experiences for patients and providers.  She describes some of the innovative new products and services that have recently been developed by entrepreneurs, like an online diabetes management support group and an app for spine surgery patients to better understand their diagnosis. 

But can a few gadgets really save health care in the US?  Probably not, but it may help some people have better outcomes.  Here's a few other reasons why launching a bunch of technology solutions at health care will not save the system.

1. Too many payers and a lack of transparency.
 Many restaurants have their menus, including pricing, posted outside the front door.  Ever seen this at a doctor's office?  Didn't think so.  Transparency in pricing of medical services and procedures is remarkably absent in a so-called private "market" for health care (I guess it is so private that the prices are hidden).  While some people may argue that health care providers don't disclose prices because they are shady people, the real reason is that prices vary depending on who's paying.  Each insurance company negotiates a reimbursement rate, individuals paying out of pocket pay another rate, and Medicare/Medicaid have yet another rate with the SAME doctor for the SAME procedure.  So posting a price list clearly becomes problematic. 

As high-deductible plans and HSA accounts become more prevalent, some entrepreneurs have developed searchable price databases.  Healthcare Blue Book is one of these, as is OkCopay.  While these don't solve the transparency problem, with people becoming responsible for a larger portion of their health care payments, such databases may force physicians and hospitals to compete on pricing, potentially reducing some of the out-of-pocket costs for consumers.

2. Technology requires people who can effectively use it
3/4 of physicians say that electronic health records distract from patient care.  Less than half believe that electronic health records are designed with physicians in mind, and the percentage of physicians who have a favorable opinion of electronic health records has decreased from 39% in 2011 to 32% in 2012. Design may be a large part of the problem with successful use of digital technology in health care, but that's only part of the answer.

Your new app may be super easy to use, but integrating new technology into an existing organization with its own culture is about more than just learning how.  People come with all kinds of preconceptions about how technology can enable or hinder their goals.  And they might feel like the new technology is just out of place with their daily activities. Enter Christian Briggs and Kevin Makice of SociaLens, who have developed an assessment tool for organizations aspiring to implement new technology, measuring what they call "digital readiness."  Understanding digital readiness can help an organization (or an entrepreneur) to figure out how users might respond to an innovative technology in the context of their work environment.

3. Human error.
The recent story about a nurse throwing away a kidney that was being donated by a living man to his sister illustrates that no matter what else is going on, and no matter how important the task is, people do stupid things.  Wasteful things.  Things that can kill people.  200,000 people die every year from preventable medical errors, more than the number of those who die in car crashes each year.

There is no technology that can completely solve this problem, but if patients have better ways of educating themselves about their health and health care through the use of new technology, we stand a chance at being advocates for ourselves. 

Technology has the potential to drastically change the way that health care is delivered, financed, and taught.  But it's no panacea.  We need to be aware of the ways in which health care, technology, and culture interact when proposing new user-friendly designs.

No comments:

Post a Comment