Information on the medical field in the 21thcentury.
Answers
Answer:
By the time I saw Mr. Johnson (not his real name), he had received three CT scans in less than 24 hours — and we had done nothing to make him feel better or cure his clinical problem. The day prior, he had seen his primary care physician in rural Maine for fever and belly pain, and had a CT scan which showed an abscess in his abdomen. At the nearby emergency room, where he went next, another physician, unable to obtain the original films, reordered the CT scan. The ER physician was about to hospitalize the patient when Mr. Johnson reported being a veteran and was promptly transferred to the Boston VA. The films were misplaced during his transfer to Boston and after arriving, he had — you guessed it — yet another CT scan confirming the abscess. All that diagnosing and still no treatment! Although this true story is alarming, it’s hardly atypical for our $2.5 trillion healthcare system.
U.S. healthcare is at a crossroads. For the past century, healthcare has been a cottage industry. Patients saw doctors who had a distinctly limited set of tools: maybe a couple of dozen medications and a few surgical interventions
Explanation:
PLS MARK AS BRAINLEITES
Answer:
By the time I saw Mr. Johnson (not his real name), he had received three CT scans in less than 24 hours — and we had done nothing to make him feel better or cure his clinical problem. The day prior, he had seen his primary care physician in rural Maine for fever and belly pain, and had a CT scan which showed an abscess in his abdomen. At the nearby emergency room, where he went next, another physician, unable to obtain the original films, reordered the CT scan. The ER physician was about to hospitalize the patient when Mr. Johnson reported being a veteran and was promptly transferred to the Boston VA. The films were misplaced during his transfer to Boston and after arriving, he had — you guessed it — yet another CT scan confirming the abscess. All that diagnosing and still no treatment! Although this true story is alarming, it’s hardly atypical for our $2.5 trillion healthcare system.
U.S. healthcare is at a crossroads. For the past century, healthcare has been a cottage industry. Patients saw doctors who had a distinctly limited set of tools: maybe a couple of dozen medications and a few surgical interventions. Now, thanks to amazing scientific advancements, patients regularly survive diseases that would have killed them just 20 years ago. We doctors have thousands of medicines to choose from, not to mention the latest in cutting-edge devices and surgical therapies. However, while the care that we deliver has changed radically, the system that helps us deliver that care has changed very little.
We deliver 21st century medicine using 19th century practices — and this contradiction between the new and the old, is most obvious in the information systems doctors and hospitals use to care for their patients and communicate with each other. Today, in the year 2011, in the vast majority of American hospitals, doctors write their orders by hand on triplicate forms. The carbon copies are then faxed to the pharmacists, who likely puzzle over the handwriting to ensure they dispense the right drug at the right dose. This way of delivering care leads, by some estimates, to tens of thousands of deaths and serious injuries each year, and is easily costing us billions of dollars in unnecessary spending.
Yet, there is hope. Several forces are coming together to finally bring the healthcare delivery system into the 21st century. The first of these forces is fiscal. Healthcare costs are out of control, bankrupting companies and governments alike. We need to strike back and employing Health Information Technology, in the form of electronic health records (EHRs) is an excellent place to start the battle. It will create efficiencies by eliminating redundancy and helping doctors avoid costly errors. A second driving force is generational. The Apple II was born in 1977 — about 8 years earlier than the doctors who will graduate medical school this year. Physician practices and hospitals that adopt EHRs are attracting this new generation of young talent who grew up using computers and are rebelling against paper-based systems. The federal government has gotten involved as well, offering nearly $30 billion in incentives (as part of the 2009 stimulus bill) for doctors and hospitals that adopt and “meaningfully” use EHRs.
None of these efforts would have helped Mr. Johnson avoid the 2nd or 3rd CT scan. His doctor had an EHR, a rarity among rural physicians, as did the ER where he traveled next. The VA has had an excellent EHR system for over 10 years. The problem is that none of these systems talk to each other. Information stays in silos and doesn’t travel with the patient. Health care providers are hesitant to share data, and it may not be for the reasons you think. While people often talk about privacy concerns or technical challenges, the real issues are cultural and economic. Doctors and hospitals aren’t used to sharing their data — and many worry that making data easily accessible to their competitors will allow patients to easily switch providers. Overcoming these barriers is going to require more than the modest incentives in the federal stimulus bill.
To really transform healthcare, we need a 21st century health care system where incentives encourage sharing of data and collaboration between providers, not just care in silos. So yes, the U.S. healthcare system is at a crossroads — but we all know which path we’re going to follow. Despite the naysayers, we will modernize healthcare through information technology. We have no choice; we simply can’t improve the efficiency of the healthcare system without it.
Ashish Jha, MD, MPH is Associate Professor of Health Policy and Management at the Harvard School of Public Health, a practicing internist at the Brigham and Women’s Hospital, and a regular contributor to the New England Journal of Medicine, Journal of the American Medical Association, and Health Affairs.