By now, I’m sure everyone has formed an impression of the HIMSS12 show. Whether you are here in Vegas, or playing along from the comfort of your office, I’m sure there’s been enough coverage for most folks to form an opinion about the events going on in Sin City.
I’ve come away with a number of opinions about the show, the organization, the healthcare industry in general, and several people in particular. I’ll share just one, brief observation with you, and not bore you for too long with an opinion you may have already read 10 times in other places (and that you also may not agree with).
The theme or “buzzword” that has resonated the most with me at this particular HIMSS has been Delay. I’ve written about healthcare’s delay before, and am seeing it as a constant topic of discussion on the show floor. Whether it’s the excruciatingly long taxi queue I waited in upon arrival, the HHS’ decision to cave and delay ICD-10; the waiting, waiting, waiting for the release of Stage 2 Meaningful Use requirements; the chatter around if and when healthcare reform will be repealed; or the even more excruciating pace of trying to find any kind of connectivity at the show itself in order to make a phone call, send a text or type a tweet; it seems like the industry has decided to embrace a snail’s pace.
Now, this probably isn’t news to anyone who has worked in the industry for some amount of time. Having only been in it myself for two or three years, I am slowly coming to the realization that as much as some of the younger, start-up whipper snappers would have us believe, healthcare reform in the largest sense of the word is not going to happen overnight. There’s politics to wade through, organizational and cultural obstacles to overcome, and let’s not forget that creating and developing new healthcare IT solutions takes time. Quality outcomes can’t be improved overnight – it takes time to implement, train and adapt to new solutions, whether they’re technological in nature or not.
I heard someone at the Dell Think Tank at HIMSS12 refer to healthcare reform as being as slow as molasses, and that’s an apt description. As Americans, most of us have a mentality of “We want it and we want it now and it’s got to be perfect when we get it because we’ll settle for nothing less.” Especially where healthcare is concerned, we’ve definitely acquired a feeling of entitlement. We want the best, quickest, cheapest healthcare money can buy. And it just doesn’t work that way.
Sure, we need to be patient. That’s a given. As Dr. Farzad Mostashari said in his HIMSS12 keynote, “Change takes time.” But for many – be they the underserved, underinsured, or under-treated, time is a precious commodity. Healthcare needs to pick up its pace so that patients don’t get left out in the cold.
“Buzzwords”?
There are two, that are unchanged (and yet to be realized) in the nearly 20 years I’ve been around health care:
“Transformative”
and
“Transparency”
Do you want more rapid change in health care? The get government out of it.
MU Stage 2 is one rule. That’s all. It has taken years to formulate, and it will be another 6 months to finalization of the rule, then another 2-3 years to adoption. And while all this is going on, there have been no significant innovations in EMRs – every vendor has been frozen in place, afraid to make changes lest they lead to incompatibility with MU. From end to end, MU Stage 2 will have taken 5 years or more. All 3 stages will take 10 or more. Do you know of any other field in which IT development has been held in stasis for 10 years?
The author seems to think that government-driven reform is the solution to society’s problems with health care. She couldn’t be more wrong – government involvement in health care IS the problem.
In 1960 American healthcare was undoubtedly the best in the world. It wasn’t perfect, but there was none better. In 1965 medicare was introduced. In the 1970s govt realized medicare was deeply flawed, and began attempting to change the system. In the 1980s government instituted DRGs, began to regulate how physicians must behave, and how they could get credentials, and began to directly legislate certain forms of health care provision. In the 1990s government introduced RBRVSs, accelerated the use of JCAHO as a hammer to knock hospitals into line with medicare’s desires, and continued to politicize medical care. In 2000 the government retreated from the failure of HMOs, but tightened the noose on hospitals and physicians in terms of meeting CMS’s “idealized” behavior and quality standards. In the 2010s, government is returning to the managed care concept, and is beginning to use EMRs as a means of gaining compliance from hospitals and doctors with government’s wishes. And now, rather than being ranked as the best health care system in the world, we rank 38th. Way to go, government…
I’m reminded of what Adam Sharp, MD,
Founder par8o & SERMO posted on par80 a few weeks ago:
“The goal of EMRs is to wrestle control of healthcare away from the doctor-patient relationship into the hands of third parties who can then implement their policies….by simply removing a button or an option in the EMR. If you can’t select a particular treatment option, for all intents and purposes the option doesn’t exist or the red tape to choose it is so painful that there is little incentive to ‘fight the system.’”
http://par8o.com/wordpress/why-emr-is-a-four-letter-word-to-most-doctors/
But we already knew this, didn’t we?
The one thing that has bothered me about the current state of emr/ehr solutions is the focus on meaningful use as a selling point. Shouldn’t the focus be on streamlining the product and accurately documenting the encounter?