Haste makes waste

By UYLESS BLACK

Special to The Press

In December 2008, President Barack Obama declared his administration was pushing for a national effort to automate (digitize) the vast paper files of America’s health care system. His commitment to digital medical records was part of an ambitious stimulus package for the U.S. to recover from the near-disastrous financial meltdown.

The effort would supposedly lead to electronic health records (EHR) throughout the nation. The president claimed; “We will make sure that every doctor’s office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year.”

Even a Congress hostile to Obama’s tenure got on board. This body had been led by former House Speaker Newt Gingrich, who stated it was easier to track a Fed Ex package than to track one’s medical records.

In 2005, I listened to Gingrich speak at the National Press Club in Washington, DC, and later had a brief conversation with him.

Mr. Gingrich’s emphasis was the health care system in America. The gist of his presentation and brief talk with me was that the government programs were dangerously out of control and the continuance of present policies would lead to catastrophic problems for America in the future.

He said, “If we don’t change our way of doing things, we will not succeed.” He stressed the need to get rid of paper records and to digitize them. (It is likely that Newt did not receive much support from the paper industry lobbyists.)

Congress followed Newt’s advice, even though he was no longer in Congress. In 2009, in spite of its disdain for Obama, Congress passed the HITECH act, which allocated billions of dollars for a national EHR initiative. Not millions, billions.

How many billions? Thirty six of them, as in $36,000,000,000. To what result? One can agree or disagree with the answer to this question but the following assertions are taken from comments of doctors about this issue (see the end of this article for the sources of these studies):

The EHRs they used had helped them, but 59 percent of the doctors stated their EHRs needed a complete overhaul. They also said, “The systems had detracted from their professional satisfaction (54 percent) as well as their clinical effectiveness (49 percent).”

One doctor offered, “Everything is so cumbersome. It’s slow compared to a paper chart.” One of the studies claimed a doctor (or an assistant) had to make several thousand mouse clicks during a shift. Even the most diligent key-boarder is going to make mistakes while doing thousands of entries.

The opponents of the current EHR situation state some entry errors led to severe consequences, such as erroneous treatment of a patient, even the death of a patient (very rare).

From the perspective of this writer, a layman in the medical world but somewhat versed in computer software, it appears Uncle Sam’s 36 billion dollars bought a mixed bag of effectiveness.

Is this result satisfactory? After all, large software systems are complex. They can strain the mental powers of even the most gifted humans. As explained in the next part of this series, the U.S. government’s EHR programs are not satisfactory, regardless of the $36,000,000,000 expenditure. It is an expenditure straight out of the wallets and purses of the taxpayers, you and me.

We shall see how this software debacle came about. As well, this series will examine the Boeing 737-M software disasters and a personal experience this writer had with software that was used to manage our nation’s money supply and interest rates.

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These articles have used the following sources: khn.ort/ehr, fortune.com/longform/medical records (which cites the Stanford Medicine’s 2018 National Physician Poll), Fortune magazine (April, 2019), U.S. Department of Health and Human Services.

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Uyless Black has retired from writing computer code. Living in Coeur d’Alene with his wife Holly and pup Lilli, he now spends much of his time writing books about a variety of subjects...none include the subject of computers.