The Problem with Healthcare IT: The Closer We Get to the Goal, the Farther Away the Goal Seems to Get

Farzad Mostashari recently said that 5 percent of the problem in healthcare now is people while the remaining 95 percent of the problem is systems and IT.

According the national health IT coordinator, as reported by Government Health IT, “It’s systems that let ordinary people do extraordinary things.”

However, the tools that allow us to do extraordinary things contribute to nearly all of the problems physicians and their practices face in healthcare. IT is to blame for healthcare’s problems; not lack of payment reform, overarching government intrusion, lack of research, the fact that doctors are only able to spend about eight minutes with each patient per visit, etc.

Nope. None of these factors matter. Apparently, according to Mostashari, all problems in healthcare are IT related.

Am I making a mountain out of a mole hill? Most certainly, many of you will say. But, this is the type of statement that’s made by an individual seeking job security. If all of healthcare’s problems are IT related, who better than to help fix these problems than the national health IT coordinator.

To be clear, I have no issue with Mostashari and I actually think him to be a pretty likeable and competent fellow. In fact, much of what I’ve read about him and the articles I’ve seen him produce make sense.

But this is too much. Healthcare had its share of problems long before IT came along and exacerbated them. Certainly, IT comes with its own set of problems, but meaningful use, for example, has not helped clear up or do away with any of these problems. In fact, it’s probably made the problems worse – more time spent managing an overwhelming amount of data collection, engaging patients in ways in which many physicians simply are not qualified and making the patient’s record, rather than the patient, healthcare’s king.

Of course, there are many healthcare IT problems and as Mostashari points out, across the landscape, data and information needs to scale and become much more free flowing. I, as a patient, should have much more access to my information, be it through a portal or other connected manner.

But, here’s one statement where I think he’s missing the point: “How do we get that to spread? That’s going to be probably the most interesting challenge for the next few years,” Mostashari said. “It’s going to mean new roles for the entire care team, including the patient — onward!”

The promise of reform for healthcare was not about adding staff and specialized corporate-like workforces to the practice setting to manage data and information exchange, the promise was improved healthcare outcomes at the individual and population level and more efficiency – like automatic flow of information – through the EHR.

“We’re about halfway through the process of computerizing and digitizing America’s hospitals and doctor’s offices,” Mostashari added, “and we’re about 5 percent of the way through changing workflows and redesigning care to take advantage of those technologies.”

I’ll point out again that the second part of his statement was not part of the original deal that sold this reform and as we get closer to original goal, it’s beginning to feel a lot like someone is keeps to moving the goal or changing the game while it’s in progress.

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