EHRs and the Healthcare Productivity Paradox

7 11 2011

I think there are few places where opportunities for improvements are as great as they are in healthcare. Who hasn’t been hit by devastating healthcare news, treated poorly, or had the impression that going through the healthcare system is like moving through stove pipes one step after the other? For an industry that works on supposedly ‘negative demand’ according to econometric norms, it’s growing like a weed as aging populations in western countries are turning financing for healthcare on its head.

You’re probably wondering why I am blogging about this. Well, there are a lot of similarities between social media and the current evolution of our healthcare consumption. Extanz and its sister company Sterena (healthcare research and communication) have always been interested in healthcare. In fact, back in 2007, we thought the two enterprises would be one, and our first client was Syndicom (a thriving online network for surgeons). Early adopters are/were rare in healthcare though, so we diversified. But healthcare is still one area where we see many opportunities for change and improvement through participatory and social technologies, business intelligence and solving big data issues. We’ll be blogging more on those topics as we enter 2012.

Last week, I read a Austin Frakt post on labor productivity in healthcare, where they stated that healthcare is the only industry that “has experienced no gains over the past 20 years in labor productivity, defined as output per worker”. Ah, what???? Digging around in the blogosphere to substantiate this claim, I stumbled on some other interesting data points and points of view, which I thought I would share here….

It’s not a ‘US only’ problem: The NHS in England has spending cuts planned over the next 10 years, which will become the equivalent of creating a 400% increase in productivity per annum, we learn from Anna Dixon. Anna continues that these improvements can only be achievable if there is a transfer of responsibility beyond healthcare professionals. Read self-care and patient empowerment. Make people smarter though technology (or hammers) and they’ll need less costly healthcare. Right? Geez, that sounds like so much like what the social media industry has been preaching to brands when it comes to consumers – empower your consumers if you want them to adore you!

The not so mighty EHR (Electronic Health Record): This has to be one of the most talked about topics when it comes to productivity in the healthcare blogosphere. This market is expected to grow six fold by 2012 to $6.5 billion. Remember ERP (enterprise resources planning) and manufacturing companies 10 years ago?? Yep. The system never fit the ways companies were operating. Now with EHRs, throwing more training at it may not be the answer, but the cost of productivity lost over the long term will ultimately be priceless, argues Paul Roemer. ERP projects were not given the choice of whether companies wanted to be sustainable. Projects were ultimately more successful though as people and processes came together early during the design phase. Dr Reece’s blog here describes reasons for poor EHR adoption rates. Studies show that EHR projects which have 40.4% adoption rate, also have a rate of failure of 30% to 50%, according to the US Department of Health and Human Services. Other studies show much higher rates, more in the 50% to 80% range. It has also demonstrated that the larger the practice (more physicians), the higher the success rate. This should tell us something. Productivity gains ultimately appear when technology works through the workflow of users. Google pulled out of EMR after all last year after launching its effort back in 2008, highlighting the fragmentation of the US healthcare system.  The move to ACO (accountable care organizations), increase in mergers and acquisitions, as well as the $27 billion in subsidies for Health IT is now putting EHR back in the spotlight again. Will these developments be the catalyst for better productivity through EHRs? The jury remains out. You need information technology + incentive models for all parties (providers, insurance, consumers) to support positive productivity growth.

They are many sources on these topics and while we’re not trying to be exhaustive, here are some starting places to find more information:

This list below highlights who is talking about EHRs the most (relevance ranked):
Then, if you’re seeking blogs discussing productivity in healthcare, these 10 should be enough to get you started (influence ranked):
This list below highlights who is talking about productivity the most (relevance ranked):
Once you’ve made your way through as many as you can, I would be interested to hear your thoughts on our current productivity paradox in healthcare and the role of health IT!
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