Backstage at the Medical Revolution
Behind-the-scenes technologies are transforming medicine -- but who's gonna pay?
Who Wants the Tab? continued...
But Brent C. James, MD, executive director for Intermountain
Health Care at the Institute for Healthcare Delivery Research, and adjunct
professor of family and preventive medicine at the University of Utah School of
Medicine in Salt Lake City, tells WebMD that electronic record systems can work
when health-care systems are large enough and have the cash, brains, and will
to make them work.
The Intermountain Health Care system, which comprises 22
hospitals and more than 100 outpatient facilities, has been working toward an
electronic medical information system for more than 35 years. "We passed a
point, just in the last couple of years, where it's showing a net return on
investment," James tells WebMD.
The keys to success, he says, were designing a system that
wouldn't make the jobs of doctors and nurses harder than they already were, and
making sure that the system was part of overall efforts to improve the quality
of health-care delivery.
"These types of systems, which we call advanced clinical
systems, are still only in a minority of hospitals," acknowledges David
Classen, MD. "Somewhere between 5% and 8% of hospitals have these advanced
clinical systems that can provide lots of clinical information to doctors and
to patients and provide the platform to act on that clinical information
through things like computerized physician order entry."
Classen, who is vice president of the First Consulting Group in
Salt Lake City, tells WebMD that about 40% of hospitals will have such systems
in place over the next five years.
In addition to the high initial acquisition cost -- about $8
million per hospital -- health-care systems have been reluctant to invest in
advanced clinical systems because early versions of these systems weren't
flexible enough to meet the complex needs of individual hospitals or physician
groups, and those systems that were tested tended to make more rather than less
work for harried doctors and nurses.
But the tide of negative opinion about advanced clinical
systems is beginning to turn, Classen says, because employers and health
insurers are beginning to demand them, and because hospital administrators and
doctors are beginning to realize that "these systems can really reduce a
lot of errors, and improve the quality and safety of patient care, "