On November 5, 2007, CCHIT announced it had certified 40 percent of ambulatory EMRs and 25 percent of inpatient EMRs. Around the same time I visited my doctor to receive treatment for a mild condition and was surprised when he pulled a tattered old formulary book from his pocket to look up the medication he wanted to prescribe. He’s a young man and wore an electronic device on his hip, and yet he turned to a book when he needed facts on medications. I realized my perception of him was wrong. I had assumed he used a decision-support device when in reality he did not. I inquired and he explained that his brain was faster and better than the database, but that he always checked himself before prescribing medications.
Our perceptions drive our actions though they can be far from reality. HMT editors are immersed in healthcare IT. We study it, we write about it, we edit stories about it—it’s a constant in our lives and we can forget that those not involved with healthcare IT on a daily basis may not be up on the latest trends and technologies. (I still encounter physicians that don’t know what a RHIO is or the NHIN.) I could have argued with my physician that an electronic device that updates itself regularly from a medication database is infinitely superior to a book that was probably printed years earlier. But what would be the point? He prefers the book to the electronics and my argument would have little sway over his behavior.
So, what’s a good patient to do? I took responsibility for my own healthcare and did my own research, starting with my pharmacist, whom I grilled about the medication. Then, I turned to the Internet and researched the medication, looking specifically for anecdotal evidence to balance the med-speak on the pharma and medical community Web sites. In the end, I chose not to fill the prescription, because, for me, the risk of side effects outweighed the reward of treatment. This turned out to be a good decision for I soon discovered the true source of the problem was not viral or bacterial but due to my own actions. I simply changed my behavior and the symptoms ceased. I also realized that while my physician’s diagnosis was consistent with the conditions I presented, he had not asked me about my activities and had jumped to a conclusion. The medication prescribed probably would not have harmed me, but it would not have treated my condition either. How much of the rising cost of healthcare can be attributed to these types of misdiagnoses? In that one encounter, transparency and pay-for-performance had both come into play.
I’m an IT evangelist. I don’t believe healthcare IT is the answer to all of the industry’s woes but it’s available, and if it can save lives or improve diagnostic accuracy, why not use it? With the Presidential elections looming, it’s likely that 2008 will be a significant year for healthcare IT. Will the momentum began by President Bush’s EHR mandate slow, redirect or dissipate all together? Or, will physicians finally see the light and start adopting healthcare IT? It seems to me that this revolution is picking up steam and that we’ll be living with a radically new healthcare system in the near future. The reality, however, may be something entirely different, but that’s my perception and I’m sticking with it.
