The year 2004 will be another good year for the Association of Medical Directors of Information Systems and our mission to advance the field of applied medical informatics and promote direct physician use of information technology to improve the practice of medicine.
Computerized physician order entry, physician adoption of IT and the electronic medical record are now the focus of truly widespread attention.
This year, AMDIS Chairman William Bria, M.D., and the rest of the AMDIS leadership enjoy the company of none other than President Bush and Sen. Hillary Rodham Clinton (D-N.Y.) in promoting the acceleration of computerization in the practice of medicine.
What a wonderful surprise. It's about time.
In a radio address to the nation Jan. 24, Bush asked for an electronic medical record, repeating the call he made in his State of the Union address. Moreover, the president said the 2005 budget he was sending to Congress would ask for $100 million, doubling the funding for promising healthcare IT projects.
In a Jan. 12 speech at Weill Cornell Medical Center in New York, Clinton nicely summarized the change in perspective the country needs today.
"Often we focus all of our effort on quantity--getting more money for coverage and more people covered," she said. "These are critically important issues, issues that I have long been involved with. But I believe that we need to examine the quality of the healthcare system as well. The aspects of the system that hamper quality improvement--the complexity and inefficiency of the system--contribute to the rising costs of healthcare. And clearly, these costs are spiraling out of control."
But getting a handle on costs, Clinton said, is only one of the potential benefits of better collection and use of quality data.
"We need a better way to share information," she said. "We need a better system so that physicians have at their fingertips all the information they need to do their job--including patient history, the latest research, drug interactions and everything else they need."
Measuring quality, carefully monitoring patient conditions and disseminating "best practices" in medicine would not only cut costs but also could improve treatments, avoid dangerous medical errors and save many lives. But despite the enormous financial and human costs of poor healthcare-quality data, the U.S. healthcare sector has been slow to adopt available IT, Clinton said.
"Average information technology spending per employee among all U.S. industries is nearly $7,000 per year. The banking sector alone spends almost $15,000 per employee. Yet healthcare invests only $3,000 per employee per year on IT," she said. "In 2002, 90% of the primary-care physicians in Sweden were using an electronic health record, nearly 60% in the U.K., but only 17% in the U.S."
Thirty years have passed since the first U.S. hospitalwide CPOE application was successfully implemented at El Camino Hospital in Mountain View, Calif. The genius of John Gall, Mel Hodge, Bill Childs, Margo Cook, John Fleming, Marilyn Davis and others enabled the local medical community to adopt 1970s-vintage IT and reduce medical errors and costs.
Yes, a community hospital--without residents and using relatively expensive technology--did improve the quality of care and lower costs, and 30-plus years later the rest of us are finally motivated and moving toward that goal.
We read and know that physician and clinician adoption of the technology is more important than the technology itself. Two medical centers attempting to implement similar software and hardware can have very different results. Involved, motivated and enthusiastic medical and nursing staffs make the difference.
Executive sponsorship, project management, change management and a proven methodology ensure a better outcome.
AMDIS physician members are excited and energetic about applied medical informatics. They finally are being involved in a serious way to support and guide their institutions to successful clinical IT implementations.
It's about time.