Stop the HIT Glitches and Delays for Better Care

Water is essential for life, but floods are destructive. Health information is essential for life, but floods of information, software, hardware, techs, consultants, and salespeople are too much -  too much for cost, too much for patients to comprehend, too much for physicians with established practices, too antiquated for new physicians/best business practice/best care.

This week is another announcement of another CMS delay/glitches that will impact physicians, their practices, and their patients. New physicians who are finally in a position to participate - may not gain the benefits. This is like the first round when some states were ill prepared to set up such a program. Delays in payment changes are no longer rare and cut into revenue - the lifeblood of health care delivery.

We would never allow high tech to be suddenly practiced upon patients via high tech surgery or high tech medicines without substantial testing, assessment, and development. Even then there would be careful observation during implementation.

But we allow HIT or Health Info Technology to be implemented and promoted in a way that has resulted in complications and consequences.

This is not consistent with "Do No Harm" - the high standard that must remain the top priority for health care. In fact, the word reckless comes to mind with regard to such implementation.

The Hypocrisy of Health Care Cost Outcry

We have numerous articles on a daily basis that blame physicians for running up the cost of health care - while somehow not seeing that we spend more and more billions for software, hardware, sales force, Health Info Techs, consultants and others that add substantially to the cost of health care - costs that steal funding and support from the clinicians and teams and their time to deliver care

When revenue is taken from practices to pay for HIT, it can cause "glitches" or delays in the health care that can be provided. Sadly these may be most apparent for patients in most need of care.

Any hope for better health care for most Americans absolutely requires a top priority focus upon spending specific to the teams and clinicians that actually deliver the care rather than so many other areas - no matter how innovative or exciting they may seem.

HIT Is Not Yet Ready for Prime Time

Much more development, standardization, and study of HIT is needed. Interfaces, databases, and other areas should be standardized. Platforms are still used that will be gone in just a few years. Updates of software and various changes in national standards (Meaningful Use, ICD-10, billing changes) are not coordinated and almost seem strung out for maximal cost and minimal benefit.

No one should doubt the potential of HIT, but the potential may actually be retarded by full scale promotion and implementation focus.

This week is another announcement of another CMS delay/glitch. These have been far too common and have gone on for far too long. 

Information Technology Cannot Heal - Time to Get Out of the Way of Healing and Those Who Can Help Remove Barriers to Healing 

Recent Works

Open Season Upon Small Health Care

Continue on to Open Season on Small Health By Big Media

Summary of Small Health Complexities

Hotspotting Has Many Spots To Consider - Simple Interpretations Are Inaccurate, Many Different Characteristics Shape the Outcomes, Not Just Geographic Location

Declines in Health Care Delivery Despite Increases in Health Spending - If We Keep Accelerating Non-Delivery Costs, We Can Continue to Remain Behind Health Care Demand

Health Care Delivery Is No Laughing Matter - Political Cartoons are Nice, but...



Blogs indicate that primary care can be recovered and should be recovered.

Dr. Bowman is the North American Co-Editor of Rural and Remote Health. He was the founding chair of the Rural Medical Educators Group of the National Rural Health Association and the long term chair of the STFM Group on Rural Health.




Comments

Post a Comment

Popular posts from this blog

Another Fine CMS You Have Gotten Us Into

Perhaps we are indeed back to the time of Another Fine Mess (Laurel and Hardy). In a mad rush to implement innovation and to save all possible costs, CMS is creating complications for people that it is most responsible to protect. As PBS and Ken Burns celebrate the legacy of The Roosevelts, it is tragic to see what has become of over a century of effort involving Social Security, Medicare, Medicaid, and health care equity. The United States has one of the most complex health designs and clearly the various designers often know not what they are doing to others. More cartoons and comedians would find this a ripe area for material if not for the suffering involved. Health and Human Services has a huge role across Social Security and US health care. CMS or the Centers for Medicare and Medicaid Services has a dominant role to play in the design of health care in the United States.  CMS can be progressive or regressive. Interestingly CMS has chosen to appear to be progressive and in
Read more

The Essential True Reform Restores Primary Care and Much More

The list of distractions from True Reform are impressive. For decades True Reform has been specifically avoided as primary care worsens within practices and from outside. The demise is most specifically about the financial design. Unless there is a focus on True Reform, there is little hope for Basic Health Access. This may not make as much sense to those outside of family medicine. Family physicians not familiar with AAFP may also be clueless. If you think that you can fix primary care with more technology, more rearrangements, more types of health professional graduates, or more expansions of training - think again. None of these have any hope of working without financial design changes - major changes. The following are various concepts that dominate the discussions at AAFP and primary care meetings and media releases of associations and foundations and institutions. Members, staff, media releases, programs, and personnel have been reviewed.  There is little about Tru
Read more

Innovation Is the Problem Not the Solution for Worsening Health

Image
Innovation is good. Innovation worship is not good. Innovation application without scientific testing or clinical trials is unethical regarding clinical interventions and should be just as prohibited with regard to health policy. Clinical trials can harm hundreds or thousands. Innovative policies can harm millions. It takes a reasonable understanding of health care, health care outcomes, social determinants, and the investments that most improve social determinants to understand the consequences arising from the innovative nightmares past, present, and future. If you review the information sources with a critical eye, you too may find that the innovative policy designs have been disruptive to care, have hurt health care where health care is most needed, have reduced access to care, and have resulted in distortions in the literature. Indeed what is accepted and published in journals seriously lacks consideration of alternative hypothesis, lacks inclusion of many pages of limitatio
Read more