From The Mystery Of Ezra Klein by Mickey Kaus:
The Education of Ezra Klein (and Barack Obama) continues: In 2007, Young Ezra Klein was full of enthusiasm about the cost-saving potential of electronic record keeping in the health industry. The failure to rapidly adopt this new technology was nothing less than an indictment of the American Way of Medicine:
I’ve never read a compelling explanation of why the nation’s doctors and hospitals haven’t broadly adopted electronic medical records. It’s not as if they’re allergic to technology. At this point, cardiovascular care employs every strategy but astral projection to keep our in rhythm. It’s not as if it wouldn’t be cheaper and easier for them. …
That all these factors haven’t spurred our private providers to incorporate such broadly appreciated technology should be one of our first signs that American medicine is not responding to the incentives we’d expect.
Comes now the RAND corporation to tell us that the projected cost-saving benefits of electronic medical records have not materialized. From the NYT‘s report:
But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services.
It turns out that electronic records allow hospitals to easily “upcode” procedures, charging more for them, while removing some of the hassle of ordering expensive tests. As Groopman and Hartzband note, the most common kind of costly medical error is misdiagnosis–and those misdiagnoses are now spread far and wide at the speed of electricity rather than carbon paper. Doctors may also be discovering something Microsoft employees discovered long ago: computers allow the exponential proliferation of bureaucratic paperwork. You don’t even need the paper.
This is one of those “I don’t get it” things. I have been hearing for years how computers and the internet would revolutionize medicine, and I guess it has in some ways. But I never understood exactly how electronic record keeping could really save a whole lot of money.
Doctors still have to examine patients. They still order tests. Old tests might be useful for comparison but new tests will still be necessary. There will still be record keeping, and I would expect most doctors to keep hard copies of all their records. But even if doctors went completely paperless how much could that really save?
No matter how you store records someone still has to read them. Even worse, the potential for a misdiagnosis (or a mis-keyed diagnosis) to come back to haunt the patient at a later date increases.
You cannot accurately predict the effect of new technologies. Computers and the internet revolutionized the legal profession, especially in regard to research and writing. But lawyers didn’t get any cheaper.
Technology is not magic.