I did a pretty controversial post over on EMR and HIPAA which compared the adoption of IT in banking with adoption in healthcare IT. I guess a lot of people have opinions on why healthcare IT hasn’t adopted technology as quickly as other industries. From that post, I got an email from Rod Bennett, MBA, MMIS, that included some interesting questions and answers about the healthcare IT industry with some other comparisons to banking. I found them insightful and so I thought I’d share them with you:
1. What factors are driving the emergence of the healthcare information technology market?
In the last few years the integration of technology is being driven by the increase in technology such as MRI’s, CT’s, PET scans, and digital radiology. Also, the health care industry is adapting like all other industries using email, websites, and building some form of semblance of a fundamental knowledge management system for information distribution within their organization. What we are seeing in the healthcare industry is what we were seeing during the tech-boom. Healthcare is slow to change for the simple fact they don’t have to, until now. They have always utilized a paper based system simply because it was working for them and saw no real reason to do anything different, it would cut into their profits.
Today however, their suppliers, pharmaceutical companies, etc., are moving into the electronic age and now healthcare is finally beginning to catch up simply because they are being forced to. Their philosophy is if it isn’t broke don’t fix it. One additional factor is the next generations of physicians are more computer literate and understand the value of computers in accessing information. Many of our physicians use the Internet on a regular basis to search for information on specific disease management research for better and more accurate diagnosis.
2. Why did banking industry spend a higher % of budget on IT than the healthcare industry?
One of the key factors is “money is a finite object” it has a definitive predictable value. It can be easily interpreted in the digital world in the terms of ones and zeros. It is a mathematical based system with a predictable outcome. People can be replaced by a computer to make a simple comparison. It is predictable and identifiable.
Healthcare on the other hand is a subjective environment. It requires the integration of humans to make a determination based on subjective information to make an outcome based decision. At this point in time the development of a new system would have to have the analytical ability of a physician, a nurse, the diagnosis process, etc. That is going to require a more advanced computer system based on artificial intelligence rather than on ones and zeros. So, there is a void in the market space simply because of the technological infancy of the knowledge required to develop it.
3. Historically, why did the healthcare industry not spend money on IT?
In their world they did. They spent money on data collection systems, not on intelligent systems simply because they don’t exist yet. The status quo still has value. However, when someone is able to capture what a physician can do based on an artificial intelligence system, we could see the shift in healthcare as we know it. The computing capacity would take a super computer to drive the system. For right now it is dependent on the medical professional’s expertise. It’s more cost effective to have a medical professional than it is a computer. How do you define a numerical value to a cough?
4. Who spent more money on IT – Insurers, hospitals, nursing homes, physicians, or employers?
I would have to agree with Ray, insurance companies by far; again it is because it is easier to measure dollars and cents. The data collection is a much simpler system because everyone is identified by a number, it’s definable. They have also spent more on providing an insurance card to the member and providing them with a numerical number for identification, again definable as a numerical value identified in an operating system.
Hospitals are spending money on data collection systems because they can identify a person in their system as a number. That’s basically what an EMR system is. It is used to track a person in the hospital system by a medical record number, assign a numerical value to a lab test, and assign a numerical value to an x-ray result. You can manually add data input by typing descriptive information. This is the current state of the EMR system and can be collected for value in the form of a numerical charge or fee.
5. What barriers existed that prevented health information from being shared among the healthcare stakeholders?
The main barrier at this point is the proprietary systems being built by providers to ensure profitability. The main barrier is the data base it is built on might be different from other data bases. It boils down to a proprietary systems equal money and profitability. Who cares about the healthcare stakeholder, they get what they get and like it, or else!