November 5, 2005
“I love mankind; it's people I can't stand.”
This was the inscription on a plaque awarded me by the nurses in the Jefferson Davis Hospital respiratory ICU many years ago after a boffo performance by yours truly if I must say so myself. They wished to recognize my work there and to highlight some of the finer points of my disposition, personality and outlook on life at the time. Thanks, ladies. Truth--even when funny--hurts.
We humans have a lot of competing and mutually exclusive ideas and behaviors. It creates a rather delightful and entertaining incoherence in our existence. It is the humor of human absurdity.
On the one hand we often love the idea of something--whether we actually know anything about it or not. We can form strong opinions about the idea of something based on the vaguest of data points even when we have never experienced it in any way.
On the other hand when it comes to the reality of actually using the idea that we love so much, we don't do it, often for the lamest of reasons.
Never has this phenomenon been played out more vividly than with the Electronic Health Record (EHR). Even The Government is now worked up in a lather over everyone getting their health records online. Everyone is for it. It's gotta be good. Right?
But what is it? Most conceive of the EHR as a better file cabinet and an electronic version of the dog-eared, coffee-stained, manila folder version. It seems everyone is for it until you have to either collect and record the data yourself or actually pay for it. I do love mankind!! Womankind too!!!
But it's gonna improve quality in some mysterious way and it's gonna improve the costs of healthcare by some as-yet-to-be defined mechanism. GIGO. Now and always. (GIGO=garbage in, garbage out.)
So I chuckled as I was reading a couple of recent reports which when ta ken together highlight our human incoherence and absurdity.
Setting the stage is the report of a WSJ Online/Harris Interactive Healthcare Poll from October 7. The headline reads: “Poll Indicates Strong Support For New Medical Technologies.”
To wit: “While few Americans have experienced new medical technologies like electronic medical records and digital imaging equipment in their doctors' office, a new Wall Street Journal Online/Harris Interactive health-care poll shows a large majority are in favor of having their doctors adopt new technologies in their practices.”
Hell, we don't know what it is but we're for it. Get the doc to pay for it!! I do love mankind!!
“Furthermore, most adults believe that new medical technologies will either reduce the costs of medical care or are worth the investment because they will improve the quality of care, according to the online survey of 2,048 adults.”
It's touching…the faith of a newborn.
It gets better: “And more than three-quarters of those polled favor using electronic medical records to capture medical information, or digital imaging equipment that allows the doctor to send pictures or other images via email. Technologies such as email and home monitoring devices ‘offer a clear benefit for patients in terms of convenience,' so that patients do not have to go into the doctor's office for simple communication or procedures.”
Anyone want to guess why there is resistance to adoption by practitioners?
Juxtapose this with the story in USA Today on October 26, “ Don't Let Hurricanes Blow Your Medical Records Away” by Judy Appleby. This is a story of several companies touting online EHR's to consumers for a fee with a pitch of safety and continuity. Now here's the question, if this is such a great idea, how come there is no one already doing it?
Here's the business side: "It's a solution that works today that would have addressed every single issue that came out of (the) recent disasters of Katrina and Rita," says Robert Lorsch, a Los Angeles businessman and founder of MyMedicalRecords.com. Got a crisis? I got a solution.
So where are the customers?
The story goes on: “Still, online medical records companies face lackluster consumer response.” Lackluster is being kind.
“One of the first companies to try the concept was run by former surgeon general C. Everett Koop. Four years ago, drkoop.com announced an online personal health record program for consumers, says Mark Bard, president of Manhattan Research. It did not take off.” They forgot to mention Koop went out of business.
"Consumers did not show up," Bard says. "They weren't sitting around saying, 'I wish there was a place I could enter all my personal health information.' "
Bard says his firm's research shows that about 30 million Americans are likely users of computerized medical records. But there's a catch.
"Consumers, even those who are interested, don't want to pay for it," Bard says. "If demand was there, the bigger portals would be deeper into it." Actually, you can give it away and no one will use it.
It has been known for at least a couple of generations now, that human beings will not keep a record except for short periods of time of high motivation when there is a perceived SHORT-TERM benefit. So, no one fills it out. People hate collecting and recording data, especially longitudinally.
This is human nature. I love mankind!!! I really do. We want it, whatever it is, but we won't use it when we get it. I'm laughin'.
What we want is access!!! To our personal information anytime and anywhere we need or want it. Not an EHR. But we're for it and we're gonna spend a lot of tax money on it and we're gonna have one, by God. But we aren't gonna use it!!!
I'm still laughin'. Really hard.
Robert B. Teague is a pulmonologist and business consultant who is based in Houston, Texas. E-mail him.
Read other blogs in this series.
