I have an appointment with the doctor this Friday and I just received the third call asking for basic information (address, SSN, birthdate, medical history, etc) and confirmation. Each call was placed by a different department here at Yale-New Haven and took about 5-10 of my time.
I understand the need to confirm and get important medical information, but is it really necessary to make three calls in order to do this? Don't the different departments talk to each other? It is well known than Yale-New Haven (and many other hospitals) have archaic medical record systems that prevent one department from efficiently obtaining information about a patient from another physician/floor/department/whatever. It's not hard to see how this leads to wastage. And this doesn't even account for the fact that medical record keeping systems across hospitals are rarely interoperable, as well.
One potential solution to this particular inefficiency problem is to create a nationwide health care IT system. This article offers some analysis on how this would be done, as well as potential costs and benefits. Some take home points:
-IT can produce savings, but this alone will not shrink the per capita health care expenditure gap between the U.S. and other OECD nations. I.e., if cost and efficiency are major concerns this is no substitute for systemic change.
-Health care IT will likely require substantial public investment. A firm that puts in an IT system that other firms can link likely faces a first mover disadvantage: there are significant spillovers from this initial investment. Other firms can reap efficiency gains from IT at a fraction of the cost, since the first firm already has done most of the work. Hence, without government intervention (i.e., funding and/or mandates), one would expect underinvestment in health care IT. Indeed, this likely explains our current state of affairs and why it took three calls to confirm my appointment.
3 comments:
Your post reminded me of this article about medical records.
I think David Brailer (PhD, Wharton) has since left the post though :(
Thanks Biomed Tim,
I liked the part of the article seeking to explain cost increases (the large residual between what IT would save and actual cost gaps/increases). I guess a lot of people have a sense of what drives health care costs here, but what I would love to see is some kind of accounting procedure that categorizes costs and compares shares and totals across a few OECD countries.
This KFF link provides a glimpse into what that might look like:
http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358
and there are a few studies out there that try to do this more explicitly. However, I can't find anything super recent. Any ideas?
-A
Atheen, I think your sister left out a key portion of any A-blog post: the oft-insightful comments left by your readers (would that I were equal to being counted amongst their midst!), and equally courteous and insightful responses posted by you.
Oh, and a post from Noor.
Mandates for IT, I think. It must happen...
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