This mole hill of a mountain.

The New York Times is wondering out loud whether the electronic health “cost savings” emperor has an empty wardrobe:

Saving money can be expensive.

Indeed, the quest to save dollars in the nation’s $2.1 trillion annual health care bill is becoming a lucrative market of its own. Thousands of companies, large and small, are pitching cost-saving ideas that range from electronic patient records to new medical devices.

It’s not all marketing hype. Experts in health policy agree that there is a real opportunity to curb health spending, which last year was the equivalent of $7,000 for every man, woman and child in the country. Studies predict a gain of as much as 30 percent in efficiency, mostly through reducing unnecessary tests and prescriptions, paperwork and medical mistakes.

It’s a really interesting article, from a viewpoint that hasn’t been heard much… Is healthcare information technology spending based on realistic expectations? The article cites the case of Dr. Richard Baron, of Philadelphia. His small practice (four physicians total) computerized their health records and processes. While the investment has “not paid off in actual dollars and cents,” it has helped “streamline the workflow.”

One of the key issues I have with HealthConnect is that it was never genuinely approached from any perspective other than being a better revenue-capturing system. Time after time, when I saw internal and external implementation and deployment teams canvass Kaiser Permanente facilities and departments, the general sentiment I heard once they went on their way was that they didn’t listen, didn’t hear, or didn’t care about “how things work” for that particular department.

For an organization that has had such tremendous local autonomy (until very recently), that’s a cardinal sin in the minds of most KP folks.

The need to break away from broken workflows (if there even is a consistent workflow) is pretty apparent across all of healthcare. But simply switching to a formalized (but still) broken process, or transitioning to a “new and improved” (but still broken) workflow doesn’t help anyone (except the well-paid implementation and deployment folks).

In an office of four physicians, there will usually be only very temporary tolerance for ineffective workflows. Things get fixed quickly. Processes are truly improved.

In an organization where one man is (recklessly) driving a project to help him sell books and repair his legacy, you see horrible tragedies like this.

I think, when you promote electronic health records looking solely at (supposed) additional revenue collection, or looking solely at (more realistic) cost efficiencies, you’re taking an easy road, and you ultimately lose sight of the possibilities for reducing preventable medical errors. Helping save lives was never a sincere part of HealthConnect. You don’t have to look far to see that. And that, I’m afraid, is its biggest failure.