Healthcare and IT

Why is the US healthcare system so outdated? I have been wondering about this for a while and this week's Economist has brought some answers. Here I am listing few important points from the special report:

• America spends some 16% of its GDP on health care, the largest share of any big country
• Recent studies suggest that fewer than one-fifth of the doctors’ offices in America offer EHRs
• India’s Apollo hospital chain has for years been using an advanced EHRs system, built locally,..., Apollo Health Street, a successful offshoot, sells HIT software and services to American hospitals, Apollo’s founder, wants to build an open-source “health superhighway” in India
• A Thai company, Bumrungrad makes innovative use of HIT, the company built its hospital-management system from scratch, Microsoft acquired this company
  
• According to RAND Corporation, in a 2005 report, if 90% of hospitals and doctors in America were to adopt HIT over 15 years, the health system could save some $77 billion a year from efficiency gains, if health-and-safety benefits are taken into account, the gains could double, saving about 6% of the $2.6 trillion that will be spent on health care in America this year
• A study published in the Archives of Internal Medicine in January compared a group of hospitals in Texas that has adopted advanced HIT systems with a group that has not. It found that the first group suffered 15% fewer deaths and 16% fewer complications, as well as enjoying lower costs
• In March Kaiser Permanente published evidence in Health Affairs showing that its digital efforts have cut visits per patient by an average of 26%, thanks to more e-mail and telephone consultations
• The fiscal-stimulus package passed earlier this year by Congress includes nearly $20 billion to create a national health-information network, including incentives for hospitals and doctors to adopt EHRs
• Challenge # 1: Top-down design of projects, which ignore concerns from doctors, hospitals and patients
  
• Challenge # 2: Ruthless bargaining with HIT vendors squeezing them out
  
• Challenge # 3: Resistance from doctors and nurses, who are not provided enough incentive to put in the effort needed to learn the new systems
• Challenge # 4: Privacy, but the technical tools to safeguard it, such as encryption software, have improved so much that this should no longer be a problem, a law passed in America last year stops insurers or employers from using genetic information as a basis for discrimination
• HIT reform phase # 1: Health-information exchanges to make sure that systems work together
• HIT reform phase # 2: May run concurrently with the first—will be the adoption of EHRs
• HIT reform phase # 3: Analysis of patient data to improve medical practice and drugs research
• One concern is that big software vendors or health providers with expensive legacy systems may try to slow things down so that they can milk their existing businesses
• A recent investigation of the NHS by the Health Service Journal found that many paper-based records are lost or misplaced. It calculated that perhaps 1.2m British patients are being treated each year by doctors without proper notes to hand

Here are more links to the special report:
Medicine goes digital
HIT or miss
Flying Blind
Getting personal
A doctor in your pocket
Fantastic voyage
Health 2.0
Sources