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 THE STAT 26Percentage of wireless customers who use their cell phones to take picturesMore Vitals
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JULY 7, 2004
A Paperless Health-Care System? At some hospitals, like Evanston Northwestern in Illinois, digital records are saving money and possibly lives. It's the start of an IT boom Mark Neaman doesn't like pens, paper, and ink. He gets especially irked when he sees doctors or nurses using them in his hospitals. Neaman is the CEO of Evanston Northwestern Healthcare. A 6,200 employee health-care provider with annual revenues of $1 billion and three hospitals and a research center in the Chicago suburbs, Evanston Northwestern is one of a small number of health-care institutions in the U.S. to go completely paperless. The $30 million project puts virtually ever process in the hospital online, from purchase orders and prescriptions to scheduling surgical bays and transcribing medical records. Even the foot-thick charts full of illegible physicians' scribbles are now neatly captured in electronic form. The project took three years, finishing in late May. All three hospitals and 50 affiliated doctors' offices are now paperless. It's very early, but Neaman says the results are promising. Doctors now receive patients' mammogram test results in a single day, compared to a three-week wait before. Errors in transcriptions and prescriptions have fallen significantly. And late administration of medication to patients has dropped by 70%. Before the big technology overhaul, Neaman's nurses spent one-third of their time reading and writing paper charts. Now they spend less than half that time on electronic charts. According to Neaman, the organization could save $10 million per year. "We think we can continue to improve that efficiency by doing things right the first time, reducing errors, and freeing up our people," he says. MISERLY IT SPENDING. Evanston Northwestern has realized the dream of the U.S. health-care system, a future where no one uses paper, test results move from lab to doctor to the medical records quickly, and where docs, nurses, patients, and insurers can easily swap info electronically. It's a future where neurosurgeons can read X-rays and test results at home and decide whether a case merits emergency surgery before rushing to the hospital. And for a host of technology companies, it's a future where hospitals and doctors become big tech buyers. Today, that future is still more vision than reality. Annual health-care spending in the U.S. will hit $1.8 trillion in 2004, according to the Centers for Medicare & Medicaid. But less than 5% of that will go into information technology -- far short of what's found in financial institutions and most other service-oriented industries. Today, health care is paying a price for its miserly tech spending. Disparate computer networks at hospitals, doctors' offices, and health insurers are incapable of sharing information. Highly trained, highly paid personnel spend significant portions of their days performing manual chores, such as writing by hand in case files and dictating case histories for transcription. RAPIDLY RISING COSTS. The situation isn't only inefficient, it can also be fatal. In 1999, the Institutes of Medicine issued findings that from 44,000 to 98,000 deaths per year occur in the U.S. health-care system due to errors by physicians or other providers. Worst of all, the soaring price tag for the creaky health-care system is growing far faster than the U.S. economy -- and becoming a potential drag on businesses burdened with rising costs. Over the past five years, annual health-care cost increases for U.S. employers averaged 11.5%, according to human resources consulting firm Hewitt Associates. In 2004, that's expected to hit 12.6%. That's why hospitals such as Evanston Northwestern are receiving intense scrutiny, as the medical Establishment and U.S. regulators eye information technology as their best chance at cutting costs and saving lives. "It's actually embarrassing [that] we're practicing health care without the benefit of sophisticated information technology," says Blackford Middleton, director of clinical informatics at Boston hospital network Partners Healthcare Systems and a professor at Harvard Medical School. WHO'S SAVING? The majority of insurance companies and other entities on the financial side of the medical sector use advanced info tech to run their businesses. But its use inside doctors' offices, nursing homes, hospitals, and clinics remains shockingly low. Basic economics explains some of the disparity. Hospitals and other health-care institutions lack the necessary capital to invest in costly IT overhauls. And efficiency gains from IT usage don't add to the providers' revenues. Rather, insurers capture those gains, because they benefit from less costly care and services per subscriber. "The fundamental reason why health-care IT hasn't been adopted is there has been a misalignment of incentives," says Middleton. It's no surprise, then, that less than 5% of hospitals in the U.S. have computerized physician order entry systems (CPOE), says Middleton. And less than 10% have replaced paper charts with electronic records systems, according to an October, 2003, report by the U.S. General Accounting Office.
BW MALL
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