A Hypothetical Story
You’re driving to your office. You’ve got a busy day and many appointments.
To your surprise, a “Road Closed” sign appears in front of you. You ask yourself: Should I take the detour, or return home?
Clearly, the detour may make you late but you’ll still be able to conduct business that day. So you take the detour.
In this hypothetical case, your mission, choices and consequences are clear. Your mission is to get to your office. You know that if you don’t, you’ll let your associates and clients down. So you immediately dismiss the alternative.
Most people would agree that our hypothetical business person made the right choice. But if we turn to a real life “road closed” situation in healthcare where the consensus approach to interoperability doesn’t work, you’d think a detour — a different approach — would be the obvious choice. Yet you find that thousands of very bright, talented, hard-working people have chosen, and continue to pursue, an approach they can’t make work.
A True Story
I am referring to the ongoing search for medical record interoperability — the ability of doctors to instantly access all their patient’s records from all their providers, at the point of care. Medical records must be interoperable if we want doctors to coordinate their patients’ care, improve outcomes and reduce the cost of care. Period.
In 2004, then-President George W. Bush created the Office of the National Coordinator of Healthcare IT (ONC) and set two very ambitious goals to be accomplished in 10 years. One was to get all care providers to switch from paper to electronic medical records. The other was to link all care providers via electronic networks so they could enjoy interoperability.
The first goal was largely achieved around 2015 at a cost of tens of $billions — even though most doctors hate their systems and bitterly resent being reduced to data entry clerks. Many have even quit medicine as a result. It’s called burnout!
But we’re not even close to achieving interoperability, despite our having spent 19 years and untold hundreds of $billions trying! You’d think that somewhere along the way, some of those working on the problem would have taken a different approach, a detour, but they haven’t! And making matters worse, while they persisted others have compounded the problem by requesting a boatload of new features.
It’s true that in the last year or so doctors have exchanged tens of millions of patient records. But that’s a mere drop in the bucket, and they have no assurance that they can access all their patient’s records when they treat him/her in the exam room. It’s highly probable that they can’t because about half of our doctors still fax records!
Without getting into the gory details, it’s clear that electronic networks, whether geographic or vendor-system based, won’t be available for years. The problems — think of them as roadblocks — have been and continue to be staggering if not insurmountable.
Have We Learned Nothing?
Harking back to the business person who took a detour, you can’t help but ask why those talented, deeply committed individuals trying to achieve interoperability in healthcare haven’t accepted reality and taken a detour. The obstacles have been enormous and the consequences have been devastating even though no one even mentions them. We’ve not only failed to achieve interoperability, but we’ve allowed millions to suffer unnecessarily, hundreds of thousands to die, and we’ve wasted hundreds of $billions!
How could this happen? Have we learned nothing? The answer is simple. We’ve allowed vested interests, tech dreamers, and perfectionists in and out of government and the healthcare industry to expand and blur our mission, garble our choices, and ignore the consequences. As a result, we have nothing — neither the interoperability we desperately need nor the other features! Making matters worse, some say it may take another ten years to complete our expanded mission!
When you ask the ONC why they persist along this path that doesn’t work, they tell you they are following the dictates of Congress. And when you ask our Senators and Representatives, they tell you they are legislating solutions because the industry isn’t achieving interoperability on its own. And so it goes!
The fact is that there have been and still are simple, easy-to-use, inexpensive alternatives that claim to solve our interoperability problem today. All we have to do is take off the blinders and try them! We certainly have nothing to lose! One is MedKaz® — a groundbreaking, patient-focused system we know works because we created and maintain it.
Isn’t it time for the realists among us to take charge, take the detour, and achieve interoperability today rather than struggle another ten years hoping to achieve it? The hypothetical business person who confronted the Road Closed sign would most certainly say yes. So should we!
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