Friday, June 15, 2007

The Antiquity of our Healthcare System

Due to an unfortunate event which started at Beth Israel Medical Center my wife had to spent 5 days in NYU Medical Center. I am not sure how NYU got the best rating in NYC, but my wife's stay and the care that she received reminded us that as if she was being treated in a 3rd world country hospital.

In our business, we always talk about work-flow solutions and how we can improve the productivity of our users. From my 5 days observation, I can tell you there is a tremendous opportunity for work-flow solutions in the health care industry. Beside the poor quality of care, one thing that struck me was the inefficiency in whole information gathering and sharing, this is a big mess.

At least for me, it's unimaginable that in a hospital like NYU all the information is still being written, no PDAs and no notebooks. Even in restaurants, the restaurant managers or waiters can go to a terminal and see what a table ordered and what will be delivered to that table. Can't we have similar system in hospitals for patients, so that each doctor or nurse would know exactly what the patient has? Can't we all have or carry a smart card where all our health care info is there? Why I should be paying $0.75 per page to get the patients records? This whole system is in a big mess!

I'll be very happy to give my input and suggestions as an outsider to Dr. Robert Glickman who is the CEO of NYU Hospitals on how to improve the efficiency in NYU from my point of view.

It was also interesting for me to learn how semantics play a role in our health care system. What is called a "mistake" for a common human being, it's being called "complication" among doctors. Unfortunately with all the legal stuff that they might be facing, doctors are stunning away to say "mistake" and instead of that they use "complication".

On a more positive note on health, my colleague Jonathan Clark who works for our Health Science group has started a new blog. I strongly recommend to read his stuff, you'll enjoy his writing and thinking.

1 comment:

RWL said...

Rafa: Sorry to hear about your troubles. Welcome to the world of clinical healthcare information services. There is no more complex information management challenge than in healthcare. Docs have been promised IT based improvements for 30 years.

Publishers have a role here: for the most part STM journal articles are unstructured. There's no way--at the moment--to create a patient profile to form a query that will return articles specific to identifying the best treatment paths.

Heathcare is a hard challenge. Medicine is practiced the way the the physician learned it 15-20 years before. Practices vary widely. About 1 in 3 patients at a large academic medical center can't pay their bill. Patients have little to no recall of what a physician has said to them. Rx compliance is about 50%. The electronic medical record (EMR) was supposed to address part of this, but 'who is going to enter the data?' Michael Porter and Elizabeth Teisberg (sp) took a stab at how to address the issues, but the answers are still a long way off.

Healthcare is unique. Who is the customer? --the doc?, the payer?, the Rx cos?, the employer? You hear about the patient as consumer--but patients don't decide the quantity or quality to consume, and don't pay for it. The only real answers can come from patient empowerment, and the flip side, patient responsibility. I realize that none of this addresses your immediate and unfortunate situation and hope your wife is better soon.

The difficulties created opportunities for publishers, but not too many of the commercial publishers taken advantage of it (e.g Up to Date and Nature have.)

(P.S. what's with the handicap icon beside the captcha? The resulting sound is a cacophone of japense and some numbers in english. Ouch.)