You may have seen (or at least heard about) the recent article published by researchers at Stanford University. The article, published in the Annals of Internal Medicine, concludes that current usage of electronic heath records and clinical decision support technology may improve administrative efficiency, but does “not appear to translate to better outpatient quality of care”. (You can read more here). Your first thoughts may have been, “Wow, that doesn’t bode well for the ICT industry! How can that be”? But before you bail out of your job or start looking for work in another industry, let me share some of my own thoughts on what this really means.
I’ve been telling HealthBlog readers, and anyone else who will listen, pretty much the same thing for several years now. The electronic record all by itself, really doesn’t add all that much value. I’ve said it before, and I’ll say it again, “it’s what you do next that counts”.
Electronic health record systems are a necessary first step in transforming health and healthcare delivery. I hope no one uses the Stanford report as an excuse for not buying or delaying the implementation of an electronic record solution. We must get health information in digital, electronic format. Yes, I know that electronic records are a pain in the butt for most clinicians. Data entry remains a barrier to adoption. Compared to pen and paper or dictation, using an EHR, especially for clinicians who lack keyboard skills, does nothing but slow down productivity—at least initially. However, we can no more continue to use pen and paper in the practice of medicine than we can go back to the days of the horse and buggy. The time has come. America is already significantly behind most other developed countries in the digital transformation of paper records. But didn’t I just say that the researchers at Stanford are right; that electronic records don’t necessarily improve quality? Yes I did.
You see, the true improvements in healthcare cost, quality and access to be gained from digital health information don’t come from the EHR itself. They come from everything else that digital data enables. And, this is why the future for Microsoft in the health industry remains blindingly bright.
The opportunity to transform health and healthcare delivery depends on improving caregiver, patient and consumer communication and collaboration. It depends on more intuitive and powerful ways to aggregate, analyze and share data. It depends on the ability to surface pertinent information to whoever needs it at exactly the right time and place. It depends on new ways to deliver information and certain kinds of medical services beyond the hospital or clinic and right into the consumer’s own home. It depends on intelligent software that can help manage the complex relationships between all the players in the ecosystem of care. It depends on robust information worker tools because clinicians are information workers. It depends on solutions that extend to mobile devices or whatever devices the user happens to be using. It depends on lower cost, highly scalable, more manageable, and very flexible cloud-based solutions.
If you don’t see where I’m going, perhaps you had better change careers or go work for one of those big EHR companies. If you totally get what I’m saying, then put a smile on your face and go confidently out into the world. Tell your patients, partners and customers about the gigantic opportunity that is before those of us who work in healthcare, health and global ICT; an opportunity and a challenge that few companies besides Microsoft (and perhaps a few others on the globe) are even capable of taking on.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft