Why is Health IT So Bad?
Published on the 31 October 2017
Published on the 31 October 2017
It is so bad and unfit for purpose that what most nurses say when I raise this issue is that it has gone beyond awful to the point where they are just embarrassed by it. No wonder. Think of any other area of your life where you would encounter – let alone, tolerate – such awful technology.
How would you feel if your bank couldn’t communicate electronically with head office? Can you imagine having a ‘cash card’ for your bank that wouldn’t allow you to withdraw cash from another branch or even another bank in another country?
Imagine your iPhone not synching and coordinating with your iPad or desktop Mac.
Imagine Qantas in Australia not being able to communicate and integrate smoothly with Qantas UK to get you and your luggage over there. Ludicrous, isn’t it?
Imagine not being able to organise your holidays, flights, travel, theatre, cinema bookings, or whatever, online or via your smartphone.
Imagine not being able to keep in touch with your friends or hobby groups via Facebook or not being able to chat face-to-face with your relatives or children in the UK, Canada or wherever else, via Facetime or Skype.
Well, welcome to healthcare where it seems that even the most basic functions that we’d have expected 10 or 15 years ago from our technology are unavailable. Numerous reports have highlighted that hospitals and health services still can’t ‘talk to each other’ at a technological level that exceeds two tin cans joined by string. I still go to hospitals where there is no wifi available or where staff have no smartphone access or email addresses.
The fancy term for this inability to communicate is ‘interoperability’, meaning, can hospitals’ or health services’ tech systems work with each other? Some hope.
The latest study from the US (Holmgren et al. 2017) shows that only about one-third of their hospitals achieve a level of such ‘engagement’.
How many of you work in places where individual wards and units can’t even do this, let alone hospitals within the same state or country? Can your Unit or hospital communicate easily and seamlessly with your local GPs?
After 5 days in a high-powered stroke unit, my poor GP didn’t even know that I’d been in there. Her immortal words were that “They usually send me a fax”. It would be funny if it were not so tragic. I’ve run an international business for over 10 years and wouldn’t know what a ‘fax’ looked like. You may as well tie the report around the leg of a pigeon.
“They usually send me a fax.” It would be funny if it were not so tragic…
The answer is assuredly not that health IT ‘needs more money’. This industry has been a gigantic money pit for as long as any of us can remember.
The poster child of this financial Armageddon has been the poor old NHS in the UK. Their Health IT debacle was finally put out of its misery, with no promised integrated health IT system to show for the money, in 2011 – 9 years after its inception and at an estimated cost of an eye-watering £20 billion.
Now, this figure is so bizarre that we really need to understand its magnitude. Try this. Imagine 1 billion seconds ticking away and every second, you throw an Australian dollar coin into a big hole. How long would you have to sit there throwing dollars into that hole? The answer, about 1,071 YEARS. A billion seconds is about 31.5 years. Multiply that by a converted $34 billion Australian dollars. It is almost impossible to comprehend such a waste of taxpayer’s money.
In Australia, our ‘E-health Record’ has so far proved to be as useful as a blind cat and at an estimated cost of $2 billion (so far) and rising.
I love my tech and gadgets and am very much an ‘early adopter’. I spent hours setting up ‘My Health Record,’ only to discover that it was basically an empty spreadsheet. After my days in the stroke unit, I asked the Consultant if all of the last few days’ data; my observations, tests, MRI scans etc., could be entered into My Health Record so that I could have them there. He smiled and shook his head as if I were a deluded toddler. “Not a hope,” was the answer.
So now, when I want to manage my personal health data, (that is supposed to be mine, philosophically at least) I go to my iPhone and its various apps and can do this in seconds or minutes, not hours or days. I can enter and see all of my data and I can email or message it to my GP or Cardiologist with a click or two. These apps cost about $10 not $2 billion.
Glance (2012) has noted that ‘It is very unlikely that the PCEHR will revolutionise health care in Australia any more than its equivalent did in the United Kingdom‘, but like an episode of the ABC’s ‘Utopia’, this will not stop governments from pouring money into such a sexy ‘flagship project’.
Meanwhile, nurses and other health professionals will wonder why they are still using antiquated and embarrassingly inept health IT systems in their everyday practice in 2017. I wish that I could tell them.
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Professor Philip Darbyshire is internationally recognised as a leader in nursing and healthcare research and service development. The Australasian College of Health Service Management called Philip: “the ‘go-to’ person for hospitals and healthcare organisations who want research and evidence-based practice demystified and moved out of the ‘too-hard basket’ and into the hearts and minds of clinicians who will use it make a real difference”. For 13 years, he led one of Australia’s most successful practice-based research departments at Women’s and Children’s Hospital in Adelaide, described by the Australian Council on Healthcare Standards as, an “example of excellence in research leadership”. Philip is a professor of Nursing at Monash University and an adjunct professor at the University of Western Sydney.