Inspired by Tim O’Reilly’s story of government beginning to adopt solutions initiated on the consumer Internet, I am trying to apply the same sort of logic to one of the more stubborn institutions in America – our beleagured, ineffective health care system.
On KevinMD’s blog he wrote recently about the inability and/or refusal of hospitals to convert to electronic health records systems.
As reported by MedPage Today, the study from the NEJM found that only 1.5 percent of hospitals surveyed had comprehensive electronic medical record systems. That’s a piss-poor adoption rate, and far lower than the dismal numbers in small office practices.
The reasons cited are no surprise to regular readers of the blog, and according to the survey, “some 30% said the return on investment was unclear, 45% pointed to maintenance costs, about 30% did not have adequate information-technology staff, and about 35% worried about physician resistance.”
Kevin says the problem is not about lack of money; that money won’t solve the problem.
The larger issue is that the current generation of digital record systems, to put it bluntly, suck.
He points to this article in the NY Times where, in turn, two recent papers are cited describing the doubts doctors express about digital health record keeping. The technology and the routines it’s based on are antiquated, “pre-Internet” in their approach. The Internet is over 30 years old. That’s beyond ridiculous.
Quoting from the NY Times article:
Instead of stimulating use of such software, they say, the government should be a rule-setting referee to encourage the development of an open software platform on which innovators could write electronic health record applications. As analogies, they point to other such software platforms — whether the Web or Apple’s iPhone software, which the company has opened to outside developers.
In the Mandl-Kohane model, a software developer with a new idea for health record features like drug allergy alerts or care guidelines could write an application, and those could be added or substituted for a similar feature.
Griff Wigley has been in the online social biz for a long time. I first met him on 
