As the march of health IT continues, it continues to face problems with creating a culture that supports its use. For every step forward, decades of healthcare tradition seem to be pushing progress two steps back. Here's just a few of the key challenges to health IT success that still haven't been resolved:
Recent reports have indicated that EHRs break down far more often than publicized, in some cases, crippling hospitals until they are repaired. One highly-publicized case of an EHR failure at Rideout Health in California was caused by the failure of a High Volume Air Conditioning (HVAC) unit that was supposed to keep the servers cool. Anyone with a PC knows that high temperatures will cause pretty much any computer hardware to fail. What's more, the rules of server maintenance are fairly simple—keep the room cold, have redundant HVACs, and employ an early warning system that alerts the administrator of any undue increase in temperatures. For anyone in tech installations, it's a kindergarten lesson, so it seems incredible that this kind of error can still occur.
Addressing Physician Concerns
Physicians have, through the AMA, created a cottage industry out of refusing to adopt technology. Even though health information systems were first developed in the 1960s, and the insurance industry has been computerized for decades, doctors have been resisting using that tech for almost as long. Granted, physicians have fallen in love en masse with Apple's iPad and related products, but those applications are clinically-related. Administratively, physicians have been historically resistant to using EHRs,arguing that the systems largely remain clumsy and time-consuming to use. And in some cases, they're clearly right, which makes the situation worse.
Leveraging Meaningful Use
Since the inception of meaningful use, HHS has tried to balance the carrot and the stick in bringing providers on board. Those who set goals and meet milestones—and can prove it—will be rewarded. Those who can't get it together will eventually see a reduction in Medicare reimbursement. Okay, the stick isn't as big as the carrot, and the size of that stick shrinks with every deadline extension. Technology has unlocked incredible advances in the treatment of patients, increasing not only life expectancy but also quality of life. But it's still painfully difficult to bring all stakeholders on board.
Fortunately, the healthcare industry should soon have a new crop of clinicians rising who have come up using EMRs and other health IT tools from the get-go. And they're eager to become health IT experts. In a recent study, it was demonstrated that clinical informatics is a high interest discipline for medical school students, though the training hasn't caught up with the demand. Once medical schools step up and start providing more comprehensive CI training, up and coming doctors will integrate CI thinking effortlessly into the future of their practices and hospitals. Until then, however, we'll just have to see whether late adopter physicians can handle the whirlwind of changes already underway.