As we start the new year 2016 and we get ready to execute on our personal and professional resolutions, we should ponder on how we have “successfully” and “creatively” destroyed the USA healthcare system with business and technology while at the same time allowed the systematic pilfering of $31 billion by many corporations and individuals that have yet provided little or no value in return.
Somehow the government decided that the proliferation of EMRs (Electronic Medical Records) and ICD-10 coding would help improve the outcomes of the healthcare system in the USA by improving the quality of care and reducing costs at the same time.
What the government fails to understand is that technology is not something that can be forced into use. Technology is something that is adopted because it is welcome and it’s the right time for it.
PCs were welcome in the 80’s and subsequent decades because they were nice clerical tools that eased work and provided others with a creative outlet to develop programs, games and graphical applications.
PCs were not forced into being used, nor did the CEO of an organization have to provide a bonus to the employees to use the computers as the government did with doling out over 40 thousand dollars to each physician they wanted to adopt an EMR.
The personal computers eased the workload and the employees were happy to adopt the new “revolutionary” technology. And of course, since the PCs, which initially were intended and designed as hobby kits in Albuquerque, New Mexico, and at which time the vision of having a PC in every household would have sounded ludicrous, had an army behind the scenes building games and other entertainment software that would be used by those that had to simultaneously use the computers for work. Many users would spend more than 4 hours of work time in the work day playing on the computer since their productivity was twice what it was previously without them.
ICD-10 is a coding system, that among other banalities attempts to capture if your water skis caught on fire and injured you in a subsequent encounter, that promises in helping improve healthcare. Will the granularity of the coding help improve healthcare outcomes or will it create more complex requirements to process and understand the massive amount of data being absorbed? ICD-10 has 5 times more codes than ICD-9.
The obvious untold truth of forcing technology and coding into the throat of the healthcare system is to be able to track and attempt to control the spiraling costs of healthcare. Technology and coding wouldn’t be necessary if there was the political will to control downright negligence, abuse and fraud.
Forcing a physician or a clinician to use inadequately designed software products and overly complex coding systems is not going to prevent negligence, abuse or fraud. As a matter of fact, they can be magnified.
Abuse is a major cause that has led us to this pervasive situation with our healthcare system. Fraud is another one.
Abuse and fraud are mostly committed by individuals hiding behind the curtains of sophisticated organizations. Both abuse and fraud require the orchestration of many participants. Most participants are innocent and simply following orders from the leaders of the complexity induced organizations. The proliferation of inadequate EMRs and the forced adoption of ICD-10 have added complexity to the healthcare environment. Those that commit fraud love complexity. Complexity provides a forest to hide under. Don’t forget the “too big to fail” approach with an overly-complex, regulated financial system.
It’s a ridiculous idea to let bureaucrats and corporations determine the fate of the healthcare system. It’s a preposterous idea to let them pretend they are managing the health of the nation!
Meanwhile, we have destroyed the healthcare system by forcing the doctors and clinicians into a state of misery. Most doctors in the USA want to quit practicing medicine. They are the most dissatisfied professionals in the workforce.
In a recent poll most people responded that they trust a mobile health app more than the doctors. This poll was obviously performed with healthy people because once a person discovers that they have a chronic disease or a life threatening one I’m absolutely sure they would trust their care givers more than any mobile app developed by a geek that has no idea of healthcare.
Many technology people are doing a huge disservice to healthcare. Some technologists and Health Information Technology companies have become the 21st century snake oil salesmen by selling what they can’t deliver or simply can’t be delivered.
Before 2009, being in healthcare technology was an honor. Today it has become sort of a shame. Let’s turn this around immediately. Being in healthcare should be an honor for all of us involved.