Health care in the United
States is not doing what many of us in
this business have worked long and hard for it to do. Our training prepared
us to look at a problem, weigh the various options for solving the problem,
put the solution into action, and move on to the next problem. This is how
we have gotten so many advances in health care over the past 40 years. But
we have never been able to solve the most troubling problem facing health
care, and that is cost. We have seen great ideas that were not brought to
market or were limited in use because of costs, often because the cost
would be much lower than what was presently in place—not higher, as
many of our leaders preach to the uninformed public.
The insurance companies, politicians, lawyers, drug
companies, and the press have been able to “guide” us into
believing that the present system of “pay until it hurts, than pay
some more” is the best health care system in the world.
Unfortunately, many of the physicians have fallen for the “we are the
best” campaign and ignore what they see every day because they do
not want to rock the boat. But there is a light at the end of the
tunnel.
Recently, Wal-Mart rolled out a plan in which a 30-day
supply of many generic drug prescriptions would be filled for $4. But
if you have insurance, you get the prescription not for $4 but for
whatever your copay is. Why not all the same? Simple: The cost of filling
out the insurance forms has to be covered. The store can track
everything you buy when you use a debit or credit card, and also when you
use the courtesy card that is on your key ring.
But insurance companies will not take electronic records for a drug purchase. Something is wrong with this.
Other retailers are following suit. The big drug store chains are slow to
follow, but they will.
Wal-Mart is also testing “walk-in” clinics
in many of its stores, as are several drug store chains. Why go to a
hospital emergency department or a walk-in medical center, pay $300 plus,
and wait for hours when you can go to a retail outlet and be seen in
minutes for $50 and then do your shopping? Recently, my wife got her flu
shot at the local supermarket—not at a clinic or a physician’s
office—and it was quicker and cheaper.
Technology has allowed health care to migrate out of
hospitals and physician’s offices into many other settings that are
cheaper to operate, but our health care costs are still going up and our
leaders allow it to happen. Technology can further reduce health care costs
if it is properly applied and maintained. We can reduce operating costs to
offset capital purchases when technology is properly used, but too many of
the “pundits” look to blame technology instead of embracing it
as a way to achieve cost savings.
What should we be doing to push the technology
advances? First, we are the technology experts—not the pundits. We
need to be vocal about what technology can do and why many older devices
should be replaced. Yes, they may still work, but what do they cost
compared with newer technology in terms of energy, user time, patient
throughput, and space? Think about all the space, power, water, and
man-hours that are saved when a PACS system is in place. The same holds
true for electronic medical records, for connectivity between computer
systems, voice-recognition systems for medical records, electronic
prescriptions, bar coding, and multi-slice CT, just to name a few areas
where major savings can be achieved with technology.
Some closing points to think about. For many years our
profession has pushed health care forward. We have created many new
devices, we have saved many lives, and we have helped many people lead
better lives with our advances in technology. We have seen many changes in
health care, but many more are coming. I just hope that the light that
we see at the end of this tunnel is better health care and not a train
coming at us.
Most importantly—thank you—for supporting
technology in health care. You are making the world a better place with
your efforts.
Have a great holiday season.
David Harrington, PhD, is director of staff
development and training at Technology in Medicine (TiM), Holliston, Mass,
and is a member of 24x7’s editorial advisory board. For more information, contact
us at 24x7Editor@ascendmedia.com
What’s on Your Mind?
Got a gripe? A recommendation? Does someone or something deserve praise? Share your opinions and insights with your peers. Soapbox columns should be 700–750 words in length and can be e-mailed to jkirst@ascendmedia.com