Less Paper in the Health industry
Business Week has a very interesting article on the benefits of less paper, or even paperless, in the Health Industry. Kaiser Permanente is cited as a role model for removing paper out of their offices, and moving towards eHealth records.
Interestingly enough, cost is not necessarily the main driver, as they admit that “there is unknown, if any, cost savings benefits”. However, other benefits accrue through improved productivity, and less redundant operations because of informaiton retained in paper records. However, at the end of the day, these will translate into cost savings anyway, as well as a more environmental-friendly behaviour. Not to mention improved quality of service – invaluable to the patient, with more up-to-date information.
Unfortunately, those players that have to make the biggest investments (small practices of doctors) are not the ones that reap most of those benefits – most typically the patient, hospital, health plan, and pharmacists. The up-front cost of establishing a eHealth record for small practices is still quite prohibitive, and the disruption in their work processes is quite significant at first. Only 4% of physicians have a comprehensive system in place, and another 13% use basic electronic system.
Even doctors in hospitals have a steep learning curve – only capable to receive half their normal patient load for the first two weeks, because of disruptions due to the electronic system . But this gets back to normal after a few weeks, usually.
The Health industry, like many others, can really benefit from a Less Paper strategy - also productivity improvements, quality of service, and many other benefits – which eventually turn into significant cost reductions. This is usually best achieved by getting help from an expert – capable of re-engineering your business processes, and minimizing disruption.
This is a very interesting article. I have been researching this topic heavily and gained some interesting insights. Bottom Line: there are many known and potential benefits to Electronic Health/Medical Record (EHR/EMR) systems including:
- KNOWN: Increased Safety. Areas such as doctor/patient/specialist and pharmacy communications will increase in clarity and accuracy. Just the ability to electronically transmit prescription scripts to pharmacies vs. illegible, hand-written scripts will eliminate thousands of errors and hundreds of deaths per year.
- KNOWN: Business system efficiencies: Like any good ERP system, the ability to capture, transmit and process billing remittance and automate approval cycles and payments will eliminate weeks and sometimes months of time, postage and paperwork.
- POTENTIAL: Imagine a day when doctors have access to Exabytes of historical medical records for millions of people. At that time, very few, if any doctors will be able to say “we’ve never seen this before” or “ we have no idea what you have” because they will be using the historical data itself to help diagnose conditions based on well documented, detailed data – and sophisticated algorithms and search techniques that run statistical analyses and then identify/predict conditions based on probabilities. This should save millions of dollars annually on testing and help diagnose illnesses rapidly – saving even more time, money and lives. It may take 10, 20 or 30 years – but it will happen eventually.
There are many other ways these systems will help us save time, money and lives. The key is to get started and have systems and business models that are open, scalable, available and manage patient information securely. It’s a big job and if done well will change the landscape of medical care for generations. What do you think?
In my experience, cultural changes if the biggest obstacle to change, even–perhaps especially, change change that one knows will be most beneficial! One initiative that dates back to my time as the CIO, Xerox, U.S. addressed decreasing documents, improving work flow, shortening time-to-market and more in the Pharmaceutical Industry. The results were superb; today their is great opportunity to impact a broader stakeholder base.
Regarding the smaller medical practices–see the great “reinforcer” article in the April 11 NY Times-As Medical Charts Go Electronic, Rural Doctor Sees Healthy Change.
Sorry, my previous post was incomplete. Please delete this and post below if you like it:
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Excellent observations Francois. Healthcare as an industry is definitely quagmired in paper. Believe it or not, the original HIPAA compliance deadline mandating conversion to electronic medical records was 2003. It was subsequently pushed to 2008, and then pushed again. And here we are in 2009, and still have only a 4% adoption rate? Wow! Something is surely amiss.
And because there is such little adoption of EMR systems, and no real standards established for Electronic Medical Record (EMR) systems, interchanging information between physicians’ offices, hospitals, insurance companies, and patients is handled primarily via fax.
However, it is often said that there are no such things as problems — only opportunities. And the great opportunity here is to provide physicians with interim solutions such as fax servers on-ramping and off-ramping documents for electronic filing systems. While not Electronic Medical Record (EMR) systems, these solutions represent great “first steps” while providing significant benefits for practices of all sizes.
Form a hard cost standpoint, the ability to transform the extensive space required for medical records storage systems into profit centers such as exam rooms and other clinic spaces can often result in an ROI of less than one year. And don’t forget the savings from reduced printing costs.
Other benefits include huge productivity gains from easier and quicker access to records, and the ability to transport them electronically vs. in hard copy form. Plus, in paper form, it is quite easy to have records misplaced, lost, or find themselves in front of eyes that have no business seeing them. Meanwhile, a fax server/electronic document solution will allow a practice to secure private information, and give every document coming in and out of a practice a HIPAA-compliant audit trail! And don’t forget, all of these documents will eventually have to be scanned into an EMR system anyway, so you are getting a jump on this task as well.
So while we can’t deliver on all of the benefits of a true EMR system, what we can offer is a fantastic and AFFORDABLE mid-term solution with a tremendous ROI!
The disruptive innovation in EHR will probably come from the bottom as opposed to the tops of the various pyramids.
Google has recently introduced a free system. Since it is a buy in program, each user can decide if the security issues are important.
Meanwhile WalMart is disrupting the drug delivery business.
And there are any number of start ups that are in the process of reinventing traditional health care delivery. Once we see the effects of the new health program as devised by Congress, the landscape will change very quickly.
The adoption issue is well described by Clay Christensen. Disruptive innovations enter the market where is there is non consumption. To me, that insight says that the top of the pyramid is going to follow, not lead.