A High Dose of Tech
"Some grocery stores have better technology than our hospitals and clinics." Tommy Thompson, secretary of health and human services
Eyebrows shot up at Thompson's uncharacteristically feisty zinger a couple of years ago. Technologically backward? Hospitals, where multimillion-dollar scanners painted finely detailed images of body parts? Where miniature restorative devices were threaded through tiny tubes into ailing vessels? Surely Thompson was engaging in a bit of hyperbole.
Not so--hospital administrators knew he was right on the money. Humble bar-code scanners, ancient technology at neighborhood supermarkets, had barely dented U.S. hospitals. Most patient records were still kept on paper and stuffed in bulging manila folders. Physicians in different parts of the same healthcare system couldn't send clinical data back and forth. Some doctors were technophobes and proud of it, boasting that real docs don't touch a keyboard.
And change was vital. Hospitals were inefficient--but worse, medical mistakes were killing tens of thousands of hospital patients a year. Available technology could slash the toll. Physicians' scrawled prescriptions could be entered directly into a computer, for example, eliminating errors that were causing complications and deaths. Thompson's message to hospitals: Make it happen.
And slowly but surely, hospitals are obeying--junking creaky old computer systems, cabling high-speed networks, and pumping up information-technology budgets that had bumped along hand to mouth for years.
But the few Seabiscuits are being trailed by thousands of also-rans, and last week, Thompson unveiled an ambitious 10-year initiative with a blunt bottom line: You're not wiring up fast enough, so we'll light a fire under you. The plan makes Medicare a vehicle for pilot programs ranging from handling prescriptions electronically to moving patient records online so that caregivers--and patients--can refer to them regardless of time or place. New standards, promised Thompson, will mesh the innovations into a seamless nationwide network.
"In most technology, America is the world leader," declared Thompson. "I can use my bank ATM card in Russia. Your pet has records that are likely kept electronically so you get an automatic E-mail reminder to bring in your dog for a checkup. Don't you think we should do the same in medicine? Isn't it time to bring medicine into the 21st century?"
Even minus a federal push, the number of plugged-in medical centers has climbed. Responses to annual "most-wired hospitals" surveys by Hospitals & Health Networks, an American Hospital Association trade publication, have risen steadily. The latest survey, released last week, represents nearly 1,300 hospitals, almost 20 percent above 2003.
Already, results are evident. Patients in intensive care, who usually are watched over by nurses during off-times, are being monitored by doctors miles away (Page 56). Patients are being armed with more of their own medical information as medical records are converted from paper to digital bits. And the boom is spinning off amenities like bedside Web access and E-mail.
Hospital executives talk about saving lives, not saving money, as the reason to wire up. But the corporate community, pounded by rising healthcare costs, has also been pushing higher tech hard. Four years ago, a group of Fortune 500 companies and other major employers created the Leapfrog Group to reshape the delivery of hospital healthcare in ways that would save lives and reduce complications--and, not coincidentally, drive down costs. The sheer size of Leapfrog's members has given the group unusual muscle in dictating an agenda that includes a laundry list of 27 safety-related practices, computer entry of prescriptions, and improved ICU staffing.
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