Yes, Healthcare IT Adoption Is Expensive AND Painful!

<Mandi’s Rant>

Few topics infuriate me as much as the notion that national standards-based implementation and adoption of healthcare IT should be cheap and easy. Haven’t we all heard the adage, “You can only have things done two of three ways: fast, cheap, or well”? Considering that the “thing” we’re trying to do is revolutionize the healthcare industry, the effects of which may be felt in each and every one of our lives at some point, don’t you want to include “well” as the bare minimum of what is required? After all, this is YOUR electronic health record, YOUR data, YOUR treatment plan and effectiveness measurements. So, what’s the other way we want this “thing” done: fast or cheap?

We’re talking about an industry that takes an average of 17 YEARS to put significant medical discoveries into routine patient care practice. (Numerous sources confirm this: The Healthcare Singularity and the Age of Semantic Medicine Translating Research into Public Health Action, etc.)

17 years is an entire generation of doctors. Doogie Howser could have been born, graduated med school, and begun to practice medicince by the time any insights from his birth were applied to practice. Suffice it to say, “fast” is not a way that healthcare is used to doing a “thing”.

Let’s contrast that with the information technology industry’s acceptance of iterative development releases and planned obsolescence for enterprise AND consumer assets. The big boys (Oracle, IBM, etc.) generally cease support of older products between 7-10 years after their introduction. Your company’s AS/400 server hardware may be 15 years old, but the O/S is the latest release, and all the data on the legacy server is preserved with the latest in backup packages over a wire-speed network connection. How long have you had your laptop? How frequently have you updated your Facebook app this year?

If someone tried to sell you a 17 year-old 480DX PC with a 9600 baud modem, 5″ floppy disk, 64MB RAM, running Windows 3.11 using the argument that, although much newer, faster, cheaper, more effective technology is available it is not yet PROVEN, would you buy it?

So, healthcare – an industry which moves at the speed of 17 years of Doogie Howser medical student maturity, and technology – an industry reinvented with the introduction of the iPhone in June of 2007, are at a crossroads for how to accomplish this “thing”: developing, implementing, and widely adopting national standards-based healthcare IT within mandated timelines that fall well within the next 10 years.

It must be done “fast”, relative to the usual pace of healthcare change.

And it must be done “well”, because it is OUR health at stake.

Suffice it to say, it will not be “cheap”. And my momma always told me that nothing worth doing is easy.

We have to stop whining about how costly and hard it is to turn this ship, and start working with the ONC on how to make healthcare IT better, faster, and ultimately more meaningful to all stakeholders involved in its use.

</Mandi’s Rant>

About the author

Mandi Bishop

Mandi Bishop

Mandi Bishop is a hardcore health data geek with a Master's in English and a passion for big data analytics, which she brings to her role as Dell Health’s Analytics Solutions Lead. She fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.


  • The conversation 5+ years ago about EHR’s was how cheap and easy they would be to implement, today we’re told to stop whining about how expensive and complicated they actually are…Really, you don’t see the irony?

  • Of course it’s ironic. Unfortunately, that’s sales. And the salesfolks weren’t entirely inaccurate: EHR IS relatively cheap and easy for progressive practices who already embrace technology and align to standard communication protocols. We both know that’s not the norm; however, the hope is that it will BECOME the norm.

    There is always a cost and pain associated with early adoption, and given the pace at which the healthcare industry changes, ANY adoption within a decade is “early”. The positive collective ROI is likely to take years to surface, and the only way it will get there is for us to GET THERE – expend as much energy trying to come up with creative solutions to the root causes of the problems as we do tilting at windmills of bygone traditions.

  • Hi, Mandi!

    I believe that our team confidently took the challenge of creating something that is ‘cheap, fast and well’ with our clinic management system for Philippine doctors that is web-based, covers the whole practice revenue cycle incl. billing and one that works on all devices including iPads and tablets for ~ $30/month.

    But then again, healthcare IT adoption is one tough cookie especially when you don’t have government to back you up, too. Our country’s healthcare must be at least a decade away from fully harnessing the power of digitized records that even if the knowledge and awareness is there about its benefits – practice doesn’t necessarily follow unless a higher authority issues a decree.

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