Health care in the United States is not doing what many of us in this business have worked long and hard for it to do. Our training prepared us to look at a problem, weigh the various options for solving the problem, put the solution into action, and move on to the next problem. This is how we have gotten so many advances in health care over the past 40 years. But we have never been able to solve the most troubling problem facing health care, and that is cost. We have seen great ideas that were not brought to market or were limited in use because of costs, often because the cost would be much lower than what was presently in place—not higher, as many of our leaders preach to the uninformed public.
The insurance companies, politicians, lawyers, drug companies, and the press have been able to “guide” us into believing that the present system of “pay until it hurts, than pay some more” is the best health care system in the world. Unfortunately, many of the physicians have fallen for the “we are the best” campaign and ignore what they see every day because they do not want to rock the boat. But there is a light at the end of the tunnel.
Recently, Wal-Mart rolled out a plan in which a 30-day supply of many generic drug prescriptions would be filled for $4. But if you have insurance, you get the prescription not for $4 but for whatever your copay is. Why not all the same? Simple: The cost of filling out the insurance forms has to be covered. The store can track everything you buy when you use a debit or credit card, and also when you use the courtesy card that is on your key ring. But insurance companies will not take electronic records for a drug purchase. Something is wrong with this. Other retailers are following suit. The big drug store chains are slow to follow, but they will.
Wal-Mart is also testing “walk-in” clinics in many of its stores, as are several drug store chains. Why go to a hospital emergency department or a walk-in medical center, pay $300 plus, and wait for hours when you can go to a retail outlet and be seen in minutes for $50 and then do your shopping? Recently, my wife got her flu shot at the local supermarket—not at a clinic or a physician’s office—and it was quicker and cheaper.
Technology has allowed health care to migrate out of hospitals and physician’s offices into many other settings that are cheaper to operate, but our health care costs are still going up and our leaders allow it to happen. Technology can further reduce health care costs if it is properly applied and maintained. We can reduce operating costs to offset capital purchases when technology is properly used, but too many of the “pundits” look to blame technology instead of embracing it as a way to achieve cost savings.
What should we be doing to push the technology advances? First, we are the technology experts—not the pundits. We need to be vocal about what technology can do and why many older devices should be replaced. Yes, they may still work, but what do they cost compared with newer technology in terms of energy, user time, patient throughput, and space? Think about all the space, power, water, and man-hours that are saved when a PACS system is in place. The same holds true for electronic medical records, for connectivity between computer systems, voice-recognition systems for medical records, electronic prescriptions, bar coding, and multi-slice CT, just to name a few areas where major savings can be achieved with technology.
Some closing points to think about. For many years our profession has pushed health care forward. We have created many new devices, we have saved many lives, and we have helped many people lead better lives with our advances in technology. We have seen many changes in health care, but many more are coming. I just hope that the light that we see at the end of this tunnel is better health care and not a train coming at us.
Most importantly—thank you—for supporting technology in health care. You are making the world a better place with your efforts.
Have a great holiday season.
David Harrington, PhD, is director of staff development and training at Technology in Medicine (TiM), Holliston, Mass, and is a member of 24×7’s editorial advisory board. For more information, contact us at [email protected]
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