May 2, 2011
Will Computer Technology Fix Health Care?
By Michael D. Shaw
The US government certainly thinks so. After all, under the American Recovery and Reinvestment Act of 2009, the Feds have an incredible $19 billion in stimulus cash set aside for health care facilities that can prove that they are a "Meaningful User" of electronic health records (EHR).
The Department of Health and Human Services (HHS) extols the benefits...
That's the theory, anyway. Let's take a closer look.
Conventional paper records should always have supplied "complete and accurate information." However, there is little doubt that doctors' notes were occasionally illegible, and may have conveyed the information in a shorthand too streamlined to be understood by the lay person. Various EHR software can generate prompts and form fill-ins to ensure that nothing is left out. Cynics charge that the main purpose of this is to avoid lawsuits, fueled by the data-mining of patient records, in search of anything "suspicious."
No one can deny that EHRs allow enhanced sharing of data, but with that also comes serious privacy issues, as well as the growing problem of medical identity theft. I am less than optimistic that privacy and security concerns can ever be fully resolved. For one thing, a goodly number of major breaches of health care data have involved people who were authorized to access the material. For another, the entire culture of computer security has been compromised with the advent of social networking websites.
Many users of these sites seem blithely unconcerned that their personal information is readily available, while others have accepted this lack of data security as a sort of new paradigm of the digital age. Will this attitude change when they receive marketing solicitations clearly based on their supposedly private medical information?
Transmission of prescriptions is far more efficient and probably safer when done electronically, but can also facilitate built-in rules, whereby substitutions are forced on the patient—possibly without knowledge of the provider.
As to patients taking a more active role in their own health, or that of their family members, this has always been encouraged, and would surely be empowered with EHRs. Some doctors might complain about the foolish questions that could arise, but having ignorant patients—or those informed only by drug ads—is hardly the answer.
Opponents of EHRs raise a further objection: It is expensive to convert to these systems, and for all the benefits to the patients, there are fewer immediate paybacks to the purely business side of things. Bear in mind that these conversions must also occur in an era when many health care facilities are under extreme financial pressures.
Still, the drive toward EHRs is inevitable, although it may fall short of President Obama's goal of full digital health records by 2014. One reason the goal may not be reached is that there are precious few properly trained health care Information Technology professionals.
In 2009, experts estimated that more than 200,000 new jobs would be created in the EHR conversion effort, but Dr. David Brailer—former National Coordinator for Health Information Technology—notes that there simply aren't that many Americans who are qualified. Numerous authorities agree with him. Various blogs in the field speak of job listings that stay open for months.
To their credit, the Feds have answered the challenge. HHS has created the Community College Consortia to Educate Health IT Professionals in Health Care Program. 82 member community colleges representing all 50 states received funding to rapidly create health IT academic programs or expand existing health IT training programs that can be completed in six months or less. The colleges hope to train more than 10,500 new health IT specialists by 2012.
The programs are designed for professionals with an IT or health care background and focus on training students for the following professional roles:
There are also excellent private training resources. I recently spoke with Russell Sarder, CEO and President of New York City based NetCom Learning, a leader in IT and soft skills training. NetCom Learning offers a 40-hour CompTIA Healthcare IT Technician Course. The "CompTIA" designation means that the course meets the strict requirements of CompTIA, the non-profit association for the IT industry.
Sarder believes that one of his company's secrets of success is the excellence of its instructors, all of whom are are active practitioners and true masters in their fields. An evangelist of lifelong learning and a voracious reader, Russell has come out with his second book, entitled Learning: steps to becoming a passionate lifelong learner —available at Amazon.com.
Now that we are addressing the shortage of health IT pros, it might also help to tackle the shortage of physicians. But considering that the number of residency training positions has not increased significantly since 1999, good luck on that one.