I was just reading a great article on the KevinMD.com
blog about how an ER physician uses her smart phone to facilitate care. For
example, the author called a specialist from her smart phone, received a return
call on her smart phone, looked up medical information on her smart phone, and
even took a picture of an EKG and emailed it through a secure network from her
smart phone. None of this is really new. In layman’s terms a user makes a call,
gets a call back, looks up information on Wikipedia, takes a picture something
and sends it to a friend. Most of us have been doing this for years.
I think people need to be told about the obvious
applications of technology and I am so glad that this article spelled out the
value of technology in simple, real life terms. Still it makes me think. Why
does healthcare require laws like HITECH and ARRA and government incentives to
do what other industries have been doing for years? Apple’s iPod and iPhone
hold over 80% market share and there were no laws requiring its usage; yet, EMR
is still (despite laws and incentives) struggling to convince doctors about the
value. Maybe, EMR needs to take a closer look at the ‘value’ they are
providing.
One big problem in healthcare IT adoption is the use of
uncommon technology platforms, formats, languages, etc. None of the various healthcare
technology solutions can talk to each other with ease. With that, information has
to be entered again and again into different places or providers have to pay
for expensive fees to link the software through interface. Given there have
been some improvements with CCR, CCD, HL7, etc. but it is not enough.
Still, I am not sure this is the whole problem either. Think
about Apple again. For a very long time Apple had compatibility issues in this
Windows dominated world. Yet, iPod, iPad and iPhone dominate and even the Apple
computers have become popular enough that Microsoft has had no choice but to
create Apple compatible versions of many products. So, can we really say compatibility
is the problem? I’m not so sure. I wonder what would happen if someone came up
with something as good as iPhone for healthcare. Would adoption and perceptions
change?
I think the bigger problem is cost versus value. Healthcare
providers struggle to find a single affordable system that doesn’t milk every
penny out of the provider’s pocket. Very often it seems that every feature in healthcare
technology is an additional cost and every interface to develop connectivity
between systems or between healthcare providers is another fee. Another aspect
of cost is the money lost in long implementation times resulting from software
that is just too hard to use and/or inconvenient. These are problems that smart
phones don’t have. Features (apps) are cheap or free and I only need to pay for
the ones that I use. Also and perhaps more importantly smart phone apps are
easy to learn and easy to use. Why does EMR have to be so complicated?
The answer – it doesn’t! I think that over the next few
years we will begin to see some dramatic changes in this as life becomes more
and more app driven. We are eventually bound to see an app style EMR emerge. In
the mean time, I hope more and more providers will begin using the technology that
is already at their disposal.
