Although the news is often filled with stories of breakthrough drugs developed by a pharmaceutical giant, or a new revolutionizing procedure developed by a university, it is seldom we hear of hospitals saving patients’ lives by improving the way they care for patients and operate their business. The reality is hospitals are businesses that form part of the biggest industry in the country ($2.8 trillion dollars in 2012, $8,600 per person, 17.7 percent of GNP), and it is sad to say they lag the efficiency and innovation other industries have achieved in the past decades.
In the 1900’s, 85 percent of health care expense was on contagious diseases, such as tuberculosis, diphtheria, and tetanus – those with a very high mortality rate. Worldwide, the health care industry heavily invested to find cures to these ailments and 100 years later, only five percent of health care expenses are on these types of diseases, with a very low mortality rate.
In 2010, 75 percent of health care expenses were for patients with chronic conditions, and of those cases, 80 percent have more than one disease, so they need to be treated by more than one physician. Unfortunately, nobody is in charge of linking and sharing these patients’ health records so doctors can collaborate on the treatment of chronic diseases with co-morbidities. Furthermore, nobody is paid to prevent diseases. We have a perverse health care system – we pay by treatment of disease, instead of the lack of disease.
There are four major chronic diseases that consist of almost 70 percent of health care spending: cancer, obesity, diabetes and heart disease. Chronic diseases cause seven in 10 deaths each year in the United States. Except for cancer, the other diseases can be prevented by changes in people’s lifestyles.
Large hospitals have invested heavily in infrastructure to treat these big cash cow diseases. When a patient receives treatment by a hospital, regardless of the disease, costs are greatly increased to cover the overhead of said infrastructure. This model of operating is too expensive for most patients coming into hospitals with straightforward disorders not requiring this huge overhead for treatment. Instead, these patients could be treated in ambulatory care centers at a fraction of the cost better utilizing human resources.
Though the trends show ambulatory care centers are gaining market share in the industry, we are still years away from ambulatory health centers having the prominent place they should have, and bringing the costs of medical care back to an acceptable range for most people.
While the shift to ambulatory health centers is still far off, what may save the industry from crashing is the rapid adoption of Electronic Health Record (EHR) systems that the government is trying to push. The Office of the National Coordinator for Health Information Technology created a special program in 2009 — The Health Information Technology for Economic and Clinical Health Act — that seeks to improve American health care delivery and patient care through an unprecedented investment in health information technology which pretty much forces doctors and hospitals to not only adopt, but give meaningful use to Electronic Health Records by 2015. If they fail to do so doctors and institutions will be sanctioned.
Why is the government pushing so hard for the industry to adopt Electronic Health Records? It’s simple. Through standardized information systems it is possible to reduce costs across the industry by minimizing the need of information and process redundancies across institutions, bettering the quality of care through the quality of information in the medical record, and by leveraging data analysis and mining providing clinical and strategic information to hospitals so they can make more informed decisions across all sectors of the hospital.
Currently, the main issue with EHR systems is their slow adoption and implementation, which in turn hinders the expected results the information sharing network would create and the industry needs. Hospital adoption of at least a basic EHR system has more than tripled since 2009, increasing from 12 percent to 44 percent, but is still far away from a more desirable 90 percent or more. This problem is caused largely by economic factors. A vast majority of the EHR solutions out there are legacy systems built more than 20 years ago. It’s old technology that lacks the advantages of mobile devices, and it’s expensive technology because it does not take advantage of the reduced costs of new technologies like cloud computing. True cloud computing is an emerging trend in health care and this technology is 40 percent less expensive than traditional client server technology.
The health care industry should be able to move faster in a new competitive and more efficient market. Four big tech trends are coming in the near future to the health care industry:
1. The reduction of medical errors because of the use of EHRs with clinical protocols based on evidence. There are 126,000 deaths each year because of not following clinical protocols.
2. Sharing of a patient’s health record without any obstacle, anytime and anywhere. EHRs should work like bank systems. If money can be accessed from any ATM worldwide, why shouldn’t we be able to access our medical information from any health care provider?
3. The prevention of diseases using information technology on patient life style and influencing their behavior in a positive way. The percentage of U.S. children and adolescents with a chronic health condition has increased from 1.8 percent in the 1960s to more than 25 percent in 2007, according to the Department of Health and Human Services, and these could have been detected and prevented if we had had the new EHR software.
4. Big data analysis in health care research. It’s a new and huge possibility at hand. Millions of anonymous EHRs would provide the foundation to accelerate new medical research using computers and big data crunching methods. Molecular medicine is a kind of personalized health care based in the unique DNA we each possess. If we’re capable of analyzing trillions of data sets contained in EHRs, and to identify unique biology human profiles, the future for personalized treatments will come true.
As the population gets older and lives more years than once expected, demographics worldwide are changing dramatically. Society should demand the health care industry to adopt and use EHR software, specially the ones developed in the new millennium using leading edge technology, to reduce health care costs and to provide a better quality of life.
Jorge Camargo Boj is Vice President of Sales for Latin America at Austin-based eCareSoft Inc., makers of cloud-based software solutions for doctors and hospitals.www.ecaresoft.com