Yesterday, I had the honor of delivering a luncheon keynote address at the LifeScience Alley annual conference and exhibition in Minneapolis. Despite the major snowstorm that swept the Midwest this week, more than 1200 people showed up for this annual gathering of movers and shakes in the life sciences industries.
On my way through the Minneapolis airport, I came across the ad you see to the right. I couldn’t decide if it was brilliant marketing tied to recent events, or pure serendipity. In either case, it made me chuckle. It also aligned quite well with something I’ve been advocating for some time.
The entire nation has its eyes on Washington these days where Congress is debating the future of healthcare. No matter what you think about the debate or its likely outcome, one thing is clear. The days of practicing medicine on paper are rapidly coming to a close. Like it or not, physician practices and hospitals will need to go digital, or they will take a serious hit in how much they are paid. I’m sure some of my colleagues feel they will take a serious hit either way, and they may be right. The ROI on electronic records doesn’t come from the digital information itself, it comes from what you do with that information. In other words…… it’s what you do next.
Digital health information enables a different kind of practice. It lays the groundwork for a practice that is proactive and preventive rather than one that is reactive and only focused on disease after it occurs. It helps us achieve and measure benchmarks for best practices. It provides the data that measures quality and patient safety. It helps us reach out to our community and patients in ways previously not possible. It paves for the way for business models that are better aligned to control the spiraling cost of care while maintaining high quality. These are the rewards now being realized by some of America’s best healthcare organizations; hospitals and clinics (many of them profiled right here on HealthBlog) that have been digital for some time. Hospitals and clinics that are already using and mining their digital health data to deliver better care. Like I said, it’s not about the EMR….. it’s what you do next that counts.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft
I don't have a problem with encouraging physician and hospitals to go the EMR route; I actually think it's a good idea. What I do object to is this monetary punishment on those who don't go that route. For many of them, it's the monetary problem that's keeping them from going that way in the first place.
Maybe some of that health care money will go towards helping them get there. I actually know someone who can offer free EMR software, but the government says someone has to review it and authorize it first, and that cost is over $200,000; of all things! Can't have it both ways, if you ask me.
Unfortunately, I won't see your response, if there is one, since I don't register just to post comments, so I'll have to hope to remember to check back one of these days.
I have to agree with Mitch. Having been "electronic" for 7+ years and not received any sort of incentive, I do not care for what the government has planned. Unfortunately, the current "carrot and stick" approach is more harmful than helpful - it will bring in those practices with cash into the electronic sphere for the wrong reasons, and kills those practices without cash that simply cannot afford the cost.
It must be said that Microsoft has a large share of the blame for this reluctance of physicians to embrace technology, most of which is largely based on Windows, which does not provide the flexibility needed and tries to "nickel and dime" users. Unfortunately, since medical practice is stuck in a price-fixed situation for at least 15 years, it is simply unrealistic and immoral for a Medical Director of Microsoft to be preaching this sermon. If physicians had the pricing power of the free market, they would readily purchase whatever IT they deemed appropriate to increase their productivity and provide patient care more effectively. Current business model of price-fixed third party reimbursement cannot allow any innovation and will eventually lead to a two-tier health care delivery, just like in under-developed countries.
Mitch and Arvind,
Thanks for your thoughtful comments. I practiced medicine in the Seattle area for 20 years before joining Microsoft. Believe me, I understand the pain (and joy) of practice. It's a little unfair to blame Microsoft for the business model surrounding US medicine or for the current EMR certificaiton process. Furthermore, please don't blame the inflexibility of current systems on Microsoft.
I travel all over the world and have seen first-hand the low cost, highly flexible, intiutive solutions developed on our platform. I also know the hard work we've done to make our solutions interoperable with others. I have been one of the most vocal proponents for more affordable, commodity-priced EMR solutions especially for primary care. Because of Microsoft's deep investments in the industry, I'm beginning to see health solutions for hospitals, clinics, physicians, patients and consumers that will actually deliver on the promise of always available, truly transportable electronic health records.
Bill Crounse, MD
In the majority of the cases, we approach physicians who have had absolutely zero IT experience in their practice. Most physicians we run into don't even have computers in practice let alone practice management systems or EHRs. They are coming from a cold start, so it is unfair to say that Microsoft should share blame for the reluctance of physicians to adopt technology.
The value proposition should be first and foremost, productivity not government incentives. The use of an EHR should show an ROI through increases in productivity and more accurate medical coding. Equally as important is the quality of care improvement through patient records that can be passed from provider to provider. Providers can stay much more connected to patients and maintain continuity of care.
Government incentives should be the least of the concerns.