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From Good Products … to Diminished Physician Autonomy
Dr. David Edward Marcinko MBA
[Certified Medical Planner™]
Over time, I’m convinced that successful eHR products, and the doctors and medical professionals that use them, will eventually become commodities or commodity-like, much like the PC [hardware] is today.
Of course, getting the product “right” will cause the cost of eHRs to plunge, but it will also mean a slash in physician prestige, professionalism, esteem, social stature, employment prospects and salary. Here’s a few hints why and how this might someday [soon] occur? IMHO.
1. eHR Use Can Cause Docs’ Skills to Diminish
While electronic health records may lessen physician workloads, save time and improve patient care, adapting to the technology can lead physicians to perform in a more standardized, compartmentalized and routine way, eventually causing them to lose some of their clinical decision making and other skills.
2. Will HIT take MDs Jobs and Salaries?
Faster than you might think, robots are coming after doctors’ jobs, according to a recent article from “Slate.” And those who are most vulnerable to the rise of technology may be surprising, according to author Farhad Manjoo, whose wife is a pathologist. It’s highly trained specialists–those by definition who focus on narrow slices of medicine–who may first find themselves at least partially replaced by machines
| Stopping the Madness … Changing the Paradigm |
So, how does one stop this madness? By turning the massive amounts of personal data contained within the eHRs into a [increasingly] valuable item. And, by data mining and analyzing it, and then reselling the aggregated or drilled-down information back to other customers [insurance companies, health plans, or Uncle Sam, etc] in an enhanced form. The worth of the eHR user will be maintained, and the value of eHRs will be geometrically augmented.
From Dead to Alive
In other words, the otherwise depreciating “dead or static” eHR thus becomes an appreciating “living or dynamic” asset. But, of course, not for medical provider end-users if they won’t, don’t or can’t “own” the original raw patient data.
I even see third-party firms springing up to outsource the transfer of huge quantities of raw data, into geo-data, meta-data and more granular data forms, as well as doctors leasing eHRs on a revolving basis from the “cloud” – while never owning the actual product.
Assessment
Again, this is similar to what’s happening in the tech sector with SaaS computing. I am not sure exactly when this all will happen, but current players will either join this revolution or lose out.
Disruption again!
Paradigms will change!
End game for the docs!
Conclusion
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eHRs and Voice Recognition
Dr. Marcinko – Are voice recognition systems growing out of their infancy?
That’s the suggestion made by Dr. Eric Fishman, writing a post for Medscape Business of Medicine. Fishman suggests that while not perfect, voice recognition software solves many of the problems physicians have with electronic health records.
http://www.fierceemr.com/story/value-voice-recognition-technology-ehrs-rise/2011-09-29?utm_medium=nl&utm_source=internal
Dr. Mitch Sanders
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Doctors and FAs – Will Robots Steal Your Job?
First, they balanced your checkbook. Then they manufactured stuff. Now computers & robots are coming for the jobs of lawyers & doctors.
And so, even though you’re highly educated and make a lot of money … you should still be afraid.
http://www.slate.com/articles/technology/robot_invasion/2011/09/will_robots_steal_your_job.html?gt1=38001
Dr. Marcinko, I believe this essay reinforces your above point, exactly. Well done!
Jennifer
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De-Skilling Physicians
Dr. Marcinko, excellent post and what you described above is known as “de-skilling.” It may become a real problem with the next-generation of physicians.
IOW: Depending on eMRs and related technology.
We should drive technology – technology should not drive us!
Dr. Ashland G. Carter III
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Are Doctors Becoming Obsolete?
Dear Dr. Marcinko and Dr. Carter
David Shaywitz, MD, PhD says the idea that physicians are going to be far less important in the medicine of the future seems to be a central assumption of many next-generation health companies, an assertion that, like undergraduate Shakespeare productions set in the present day, may once have felt daring and original, but now seems merely tedious.
http://thehealthcareblog.com/blog/2011/11/25/are-doctors-becoming-obsolete/
What do you think?
Clarence
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Vendor Solicitations
I just received another email from an EHR vendor pandering to physicians to implement their technology so that they can access some usability incentive to use technology that they should already be using. Here is the offending language:
“State Medicaid providers across the country have an unprecedented opportunity to collect over $21,000 in EHR incentives in the last few weeks of 2011. If you’re already using XXXX, there are a few easy steps you can take to earn your incentive“
This is just so wrong on so many levels to me. What about you?
Dr. David Edward Marcinko MBA
http://www.BusinessofMedicalPractice.com
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Outlawing Templated Notes in the Electronic Health Record
Did you know that buried in the middle of a recent New York Times article on The Ups and Downs of Electronic Medical Records is the observation that a Medicare administrative contractor dubbed National Government Services has announced that it, on behalf of CMS, will “deny payment” for medical services that are documented in an electronic health record (EHR) using “cloned documentation.”
http://diseasemanagementcareblog.blogspot.com/2012/10/outlawing-templated-notes-in-electronic.html
Now, I opined and wrote about this almost thirty years ago when digital medical transcription services, related software and word processors first appeared.
So, it was just a matter of time until this would happen.
Dr. David Edward Marcinko MBA
http://www.BusinessofMedicalPractice.com
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Closed records can cause paralysis
Take a step back from the challenges that surround health information technology interoperability and you will recognize that market forces and a desperately fragmented healthcare system make hospitals and vendors act the way we do.
http://www.hiewatch.com/perspective/closed-records-can-cause-paralysis?mkt_tok=3RkMMJWWfF9wsRonsqvKZKXonjHpfsX56O0kXK6zlMI%2F0ER3fOvrPUfGjI4DT8RrI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D
Ted
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Digital marketing to physicians is amazing
http://theincidentaleconomist.com/wordpress/digital-marketing-to-physicians-is-amazing-and-concerning/
And concerning … on EHRs.
Aaron Carroll MD via Ann Miller RN MHA
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