My colleague Denise O'Berry, blogger for the "Just for Small Business" blog, posted a comment after my Tuesday post on the Florida Blue Cross test of using email in physician practices:
"You bet Peter! When do you think doctors will get a clue and not only recognize this as an opportunity for process improvement, but also an additional (less labor intensive) revenue stream?"
I would argue what has held back the spread of information technology in healthcare is a simple fact that IT folks like to forget: all these toys are unreliable. If Proctor and Gamble's computers crash, oh, well. Somehow, we'll still get our Crest toothpaste. If a hospital's lab computers crash, it really is a matter of life and death. Maybe only a small percentage of the time, but it happens. As for email: physicians have not historically been paid for telephone time, nor, for that matter, email time. Lawyers will be paid, consultants will, but not physicians. What was news about the Florida Blues Cross project is that there finally is an opportunity to be paid for the time.
Some 9 years ago, Netscape founder Jim Clark started "Healthscape" (later "Healtheon"), with the bravado that he was going to teach the health care industry how to run their business. He fell flat on his face, as has often been the case when people in some private industry come to "save" us poor, misguided, Luddites in health care. He blamed insurance companies and physicians for not understanding how he could help them. The problem was this: we understood all too well.
Healthcare economics are not quite the same as the rest of the world. Most importantly, we don't have the range of freedoms other businesses have - business practices that are common in other industries could rise to a felony charge in healthcare.
It's changing - somehow there will be better control over spam so that email can be an efficient tool for physicians and patients. Healthcare information is one of the top uses of the Internet by consumers. Physicians are starting to use the web to screen information for patients, and web based services for registration and appointments, routine communication and tranferring information are available or are coming. It just has to work- every time.
Physicians should be watching developments, and spend time with vendors at conferences. The obstacles to integrating IT in medical practices will be overcome and we will all be better for it.