The no-computer virus
I found this article in an old economist while cleaning my desk. I really liked this article, because it clearly describes the extend of the problems that could at least be lessened by IT, explains why interoperability is so central to IT for health care and highlights another advantage that may result from more IT in the health care sector: that people finally get full access to and possession of information about their own health.
People on the right side of the digital divide increasingly take for granted that they can go online to track their FedEx package, to trade shares, file taxes and renew drivers' licenses, and to do almost anything else-unless, of course, it involves their own health. That information, crumpled and yellowing, is spread among any number of hanging folders ar all the clinics they have ever visited, and probanly long since forgotton about. The most intimate information is, in effect, locked away from its owners in a black box.
This [the reluctance of actors in the health care industry to use IT in the back-office] has perverse consequences. According to the Institue of Medicine, a non-governmental organisation in Washington, DC, preventable medical errors - from unplanned drug interactions, say - kill between 44,000 and 98,000 people each year in America alone. This makes medical snafus the eighth leading cause of death, ahead of car accidents, breast cancer and AIDS. "It's like crashing two 747's a day." says Mark Blat
A study from the clinical reasearch centre at Dartmouth College [...] estimates that a third of America's $1.6 trillion in annual health-care spending (as of 2003) goes to procedures that duplicate one another or are inappropriate.
Estimating how much IT could save, after taking account of the considerable cost of applying it widely, is not easy. Writing in Health Affairs [...] Jan Walker and five colleagues [...] concluded that a fully interoperable network of electronic health records would yield $77.8 billion a year in net benefits, or 5% of America's annual healthcare spending. This includes saving from faster referrals between doctors, fewer delays in ordering tests and getting results, fewer errors in oral or hand-written reporting, fewer redundant tests and automatic ordering and re-fills of drugs. It does not include, however, perhaps the biggest potential benefit: better statistics that would allow faster recognition of disease outbreaks (such as SARS or avian flu).
I don't agree, however, with what the econmist sees as "the potential biggert benefit". In my opinion that is the chance to use data mining on the medical data for quality assurrance. To always evalute which treatments work and to check for unexpected side effects of drugs / specific treatments.