We all know the beginning of the story: Doctors are not only frustrated; they are literally infuriated or even pissed off.
What we don’t know is how the story is likely to end, but nevertheless it may not have a happy ending.
And who may be losing in this drama? The patient; as it always happens.
Physician salaries have been precipitating every year; to the point where their ratio of education effort to professional income is now one of the lowest and approaching, in a downwardly direction, towards the one of college professors.
Their work has been piling up. Aside from caring for the health of their patients they have to deal with massive amounts of paper work, ambiguous and contradicting regulations, frivolous malpractice suits and the consequential outrageous insurance premiums. All of these factors combined have forced many practitioners to become employees of healthcare organizations or, in a few cases, partner with others to form a large group practice. For those that partner the trend is that they end up being acquired by healthcare conglomerates and thus at the end they also become employees. All roads are leading to Rome here.
And now, if the glass of water wasn’t topped to the tipping point of surface tension breakdown, the government has forced them into becoming fulltime EMR scribers!
Yes, EMR scribers! Nowadays a visit to the doctor is sitting down on an examination bed just watching how he/she has to key away on their laptop probably inserting data that will hardly be leveraged in a meaningful way. During one office visit I clocked the span of time my physician spent on the computer, it was approximately 25 minutes. The amount of time he spent face-to-face with me was under 2 minutes; engaging huh?
Well, meaningful use of #HealthIT certainly cannibalized a meaningful encounter and consequently a meaningful outcome.
Doctors know this and they are desperate to get back to a meaningful relationship with their patients. And the EMR isn’t helping!
How did the doctors fall for this perilous plan?
It was a tricky and easy plan: “Doctors desperately need money, so let’s give them a juicy orange carrot to hook them. And for those that don’t fall for the carrot trap let’s threaten them with a big tough stick, which translates into further decline of their income by whipping them with penalties.”
Exactly how did the government achieve this? Well, it came up with the dandy idea of pilfering over $16 billion thus far! These are the billions of dollars that ended up in the vaults of the EMR vendors, billions of dollars that represent the biggest lost opportunity of improving our healthcare system.
But this is not the worst part of the problem. Who’s benefited from the $16 billion dollars? Well, the same ol’, same ol’ companies that have been sucking the money directly or indirectly out of CMS and the entire healthcare system for the past several decades. Are there any new kids in town? Yes, maybe a couple or so but these will be bought out by the Jurassic vendors.
Many entrepreneurs had naively thought this would be a great opportunity to launch that revolutionary idea that would help transform the healthcare landscape forever. I’ve never witnessed so many disheartened dreamers.
Very naive were those that thought that small, innovative startups would be able to transform our healthcare system. Weren’t they aware that the worlds’ largest software companies failed in healthcare IT? Heck, these didn’t even put a dent in the system! They walked in and out as though through a revolving door. Do you even remember who they were? I bet almost nobody does, unless, of course, you actually worked at one of those companies as I did.
What actually happened is that the same ol’ have perpetuated technical debt in our healthcare landscape. Old and obsolete technology has been propagated throughout the entire system. Pulling healthcare out of this clunky-full abysm will be as costly as the industry itself. It will cost trillions instead of billions.
Interoperability has become further elusive while these software dinosaurs continue locking the large healthcare systems into their outdated products.
Sad but true.
There are rumors that congress is lighting up the #HealthIT charcoal grill, rumor which may be the probable cause of attrition of potentially accountable HHS officials.
After lavish parades at HIMSS and other venues these officials kept on saying how successful Meaningful Use Stage 1 was and how ready we were for Meaningful Use Stage 2; which by the way just got delayed for a year, hint, hint.
Audits are necessary to unveil what is really going on. The PR stunts that have been occurring since 2010 are starting to smell like dead skunks in the closet.
The delay demonstrates that something is wrong.
EMR sales have skyrocketed in the past few years. Incentives have been doled out. So then, why is there a delay? Well, the most obvious conclusion is that there is no real meaningful use of the EMRs and they are playing catch-up.
But what is really happening is that the doctors are singing the ol’ Johnny Paycheck repurposed song: “Take this EMR and Shove it, I ain’t scribing here no more!”