William McFaul's post is intriguing but strikes me as lacking a broader insight required to properly address the nation's prospective healthcare crisis. Specifically, I believe that there may be a fundamental component of the equation being overlooked by the approach indicated. I believe that the difficulty lies in properly measuring the cost of a unit of care, and evaluating if we are doing more with less. I believe that it is established that the amount of care to be consumed over the next 20 years will be greater than the amount consumed in the past 20. The best way to measure the benefits of health information technology and other technologies is to determine how the nation can maximize both the quantity and quality of care delivered.
I am not a physician but my assumption is that as with any other profession, given better tools, the quantity and quality of work delivered improves in comparison to the utilization of inferior tools. I would assume that electronic thermometers and surgical packs are superior tools, otherwise the profession would have reverted to the former tools. The question of cost savings must take into consideration the total value added of freeing up provider resources, improving quality and eliminating opportunity cost for higher value activities.
Let's assume that the electronic thermometer saved 10 seconds per activity and assume that in some population 100,000 tests were to be performedthe net effect would be a savings of approximately $35,000 per period of time. Does the electronic thermometer pay for itself? I am assuming you can get an electronic thermometer for less than $35,000. Added to which I am assuming there are improvements in qualityat a minimum a reduction in interpretation errors reading the test from a digital display vs. an analog meter.
I respect McFaul's opinion and agree with his overall point that budgets don't shrink much over time and work does expand to fill available time. The important question to me isn't the size of the budgets. We have a responsibility to provide the right care to each patient. The question is, do these tools pay for themselves and empower both providers and patients to realize greater value for each unit of budget consumed? As far as the personal health record, if it allows both the provider community and individual patients to do more with less, PHRs add value to the system.
Aaron SeibHealthcare information architectGermantown, Md.To submit a letter to YOUR VIEWS, click here. Please include your name, title, company and hometown.
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