Computers Don't Save Hospitals Money

[HardOCP News]

A study conducted by Harvard Medical School found that computers don’t save hospitals money. Apparently the cost of installing and running the system is greater than the savings.

The recently released study evaluated data on 4,000 hospitals in the U.S over a four-year period and found that the immense cost of installing and running hospital IT systems is greater than any expected cost savings. And much of the software being written for use in clinics is aimed at administrators, not doctors, nurses and lab workers.

 

[MisterSparkle]

The last part of that snippet is the crux of this problem. If properly implemented, going computerized will be a beneficial thing.

Himmelstein said that only a handful of hospitals and clinics realized even modest savings and increased efficiency—and those hospitals custom-built their systems after computer system architects conducted months of research.

Any specialized system at this scale should definitely be researched and experimented on for quite some time before implementation. Just sad that those hospitals were the exception.

He pointed to Brigham and Women's Hospital in Boston, Latter Day Saints Hospital in Salt Lake City and Regenstrief Institute in Indianapolis as facilities with some success in deploying efficient e-health systems. That's because they were intuitive and aimed at clinicians, not administrators.

 

[Mr. K6]

A study conducted by Harvard Medical School found that computers don’t save hospitals money. Apparently the cost of installing and running the system is greater than the savings.

They might be pitched as such, but I don't think that was ever a major goal for switching to paperless systems (at least in the hospitals I work at). It's more of a record keeping/management, billing, efficiency and ease-of-use sort of thing.

 

[mustang_steve]

It also bugs me that it seems most of these implementations were done without any professional design.

That's often a recipe for inefficiency, thus loss of value recieved. It's like a wrench, use it well you can fix things, use it poorly and you can break things.

 

[Nemesis999]

The last part of that snippet is the crux of this problem. If properly implemented, going computerized will be a beneficial thing.



Any specialized system at this scale should definitely be researched and experimented on for quite some time before implementation. Just sad that those hospitals were the exception.

The rest probably listened to IBM and got themselves mired in an endless stream of vendor lock-in shitware that barely works.

 

[Azhar]

I work for a project management company and I find that the biggest cause of high cost in the technology department is due to bosses wanting to compromise on tech budget with half-way measures that either breaks, don't work, or need to be further enhanced later down the road.

I would imagine this is the case anywhere, hospitals included.

 

[MixManSC]

I'm not at all surprised.... as a prior senior network admin at a major hospital (for 6 years) and having a wife thats been a ICU nurse for over 15 years I've seen it firsthand.

"He pointed to Brigham and Women's Hospital in Boston, Latter Day Saints Hospital in Salt Lake City and Regenstrief Institute in Indianapolis as facilities with some success in deploying efficient e-health systems. That's because they were intuitive and aimed at clinicians, not administrators.

Programmers of the successful systems told Himmelstein that they didn't write manuals or offer training. "If you need a manual, then the system doesn't work. If you need training, the system doesn't work," he said."

That is the biggest problem with most systems. The systems are not designed for the users that have to use them the most - nurses and doctors. They are stupidly complicated.

 

[MisterSparkle]

It also bugs me that it seems most of these implementations were done without any professional design.

Being in a number of trades over the past ten years, it never ceases to amaze me how much businesses simply throw themselves together. 90% of business owners aren't that wise, 90% of designers aren't that good, 90% of tradesmen have been thrown together through TAFE courses. It all adds up to not much.

 

[Draax]

My province just wasted 1 billion on a computerized system which still doesn't work. I'm not so sure it's the computers that are the problem, rather the politicians and the contractors setting up the system.

 

[Outamyhead]

Well, the computers aren't going to fix themselves, nor will the servers constantly maintain it's file structure on it's own, or replace parts that go belly up. funny thing is, anything costs money to run, I don't know if Harvard knows this but, staff don't save the hospital money either *gasp!*.

And there I was thinking that the computer systems installed were there to make life easier for the staff, not save money, maybe they should figure out how to make the hospitals paperless, that should save some money (since they blow a couple of million on paper products annually), and some trees.

 

[ScreamingBroccoli]

I'm going to be graduating with a Medical Informatics degree in May.

The problem is that most of these 'systems', as in the software, blow hardcore. It's not the computers. Computers do and will improve efficiency in the industry when they get it right, but I firmly believe the government needs to step in and set up some standards before they start throwing out the money. And it may not save money right now, but it cuts down on a hell of a lot of errors that would cost the hospitals in the long run, and even prevent lawsuits.


The people who did these studies are jackasses and don't take anything else into consideration except the cash. The VA hospitals have a good electronic system, and when Katrina hit New Orleans all the paper records in all the hospitals were destroyed. Tons of people died because they didn't know what was wrong with the people. The VA clinic patients were transferred to other VA hospitals and taken care of almost immediately because of the electronic record. This article is BS, if they wanna get stuck in the stone age and make the health care system even more efficient than it already is, be my guest.

 

[ScreamingBroccoli]

*less efficient

 

[htpc_user]

They might be pitched as such, but I don't think that was ever a major goal for switching to paperless systems (at least in the hospitals I work at). It's more of a record keeping/management, billing, efficiency and ease-of-use sort of thing.

Exactly. What's the alternative here? Are they going to switch from using computers because it doesn't save them money? If anything, it's a necessary expense.

 

[az_max]

The last part of that snippet is the crux of this problem. If properly implemented, going computerized will be a beneficial thing.



Any specialized system at this scale should definitely be researched and experimented on for quite some time before implementation. Just sad that those hospitals were the exception.

It also bugs me that it seems most of these implementations were done without any professional design.

That's often a recipe for inefficiency, thus loss of value recieved. It's like a wrench, use it well you can fix things, use it poorly and you can break things.

you guys hit the nail on the head. Mgt wanted a 'turn key solution' (next time I hear a project manager use that term, I'm going to kick him in the nads), but that's not what they needed. There could be some core components that are the same between systems, but really it should be a custom written app that follows the existing flow of the specific business line.

 

[[H]ocusPocus]

Hospitals are only one piece of the "health care system" puzzle. Seems to me the greatest savings will come from having all the players in health care (hospitals, insurance companies , doctors, pharmacies, etc.) working efficiently together, sharing data, etc. This is what government should be striving for.

I agree with others that any system put in place needs to be very well thought out.

"Hey nurse, I filled out this form last time I was here, why do I need to fill it out again???"

 

[thesmokingman]

I hate these types of articles, so sensationalistic. What are these hospitals going to do, go backwards?

 

[Cannon_Fodder]

Some things aren't just about saving money, but saving time. Working in IT at a hospital I can honestly say that it helps speed up the patient care. Also accessing things electronically ensures that the correct care is given with a speed that the patients enjoy. Money is important, but not everything to these organizations.

 

[anthrex]

+1 for everything everybody is saying in this thread. Businesses gotta stop thinking of the short term and prepare for a comprehensive long term goal that might cost a bit more (often times not much more) that will save so much money and headache in the future.

 

[heatlesssun]

I hate these types of articles, so sensationalistic. What are these hospitals going to do, go backwards?

+1. Well designed and thought out tools will INVARIABLY improve any process. Sure there is a cost but ultimately if you can't design something that works and saves times and improves efficiency that can scale over time then you have a clustered process. And perhaps what they need to look at process improvement. Technology alone can't make a bad process a good one.

 

[webdev511]

The problem is that most of these 'systems', as in the software, blow hardcore.

+1. You can't just re-purpose CRM & ERP applications created for business and expect it to work in a healthcare environment.

Bill Gates should throw some of his foundation money at creating software for hospitals. It won't be free, but the cost of the application shouldn't be the barrier to implementation.

 

[hasoos]

I call BS on this article. There is no way the savings are less than the implementation costs unless you implemented an extremely expensive solution. Did they quantify how long it takes a technician to pull up medical records from a computer as opposed to to searching for a paper file? Did they quantify the amount of space and personnel needed to manage the paper records? This is complete horsecrap IMO. The only businesses that do not benefit from electronic records are extremely small businesses, and even those benefit in speed.

 

[Master Blaster]

Just put snakeoil on it. Clearly the article isn't talking about basic PCs, only specialty machines.

 

[eggrock]

That is the biggest problem with most systems. The systems are not designed for the users that have to use them the most - nurses and doctors. They are stupidly complicated.

Apple iMed, calling it now.

 

[DeFex]

+1 for everything everybody is saying in this thread. Businesses gotta stop thinking of the short term and prepare for a comprehensive long term goal that might cost a bit more (often times not much more) that will save so much money and headache in the future.

not going to happen as long as most shareholders are older and could not give a crap if the earth burns once they die.

 

[gaspah]

computers have done nothing but cost me tens of thousands of dollars, sure my income may be a result of my job in IT, but the computers I actually bought... MONEY PITS!!!

 

[Big D.]

Did they count the fact that it would take mountains of paper just to store simple data like you would on one hard drive? How about the time it would take them to search through the mountains of files instead of using the Search function?

I really doubt any real hospital could go without any kind of computers and say that they're better off that way. (not talking about hospital in Africa here, but big ones with lots of traffic)

 

[thesmokingman]

Did they count the fact that it would take mountains of paper just to store simple data like you would on one hard drive? How about the time it would take them to search through the mountains of files instead of using the Search function?

I really doubt any real hospital could go without any kind of computers and say that they're better off that way. (not talking about hospital in Africa here, but big ones with lots of traffic)

Not saying they should go back, but you do realize there is such a thing as libraries and the dewey decimal system correct?

 

[Mr. K6]

Not saying they should go back, but you do realize there is such a thing as libraries and the dewey decimal system correct?

Why are you posting this? You should have sent him a letter via the postal service.

 

[Magnus]

Except for the few posters who work in health care, most of you don't realize how bad the software is in medical record and case management. There are major hospitals in Arizona running command line programs under emulation right now! In many cases, the computers haven't replaced the paperwork, they've been added to it.

The software being used helps one department of the medical system and one department only, accounting.

 

[tjmagneto]

If somebody in administration or accounting decides to go ahead with electronic medical records without input from the end-users such as physicians, nurses and other hospital staff the project will obviously fail.

Besides money, there are other advantages like the Katrina example mentioned earlier. Before we went digital with our radiology images ( I was system admin for that at one time ) where I work there were all sorts of films not returned from loan or damaged by some calamity during storage. Heck,now that I'm back in patient care I hate wading through a massive chart just to look for things like lab results or progress reports. Now I can electronically look up important information without having to run out and grab a chart or call somebody and annoy them. Not sure how you measure that in dollars.

 

[xX_Jack_Carver_Xx]

NEWSFLASH:

Shitty software, written by morons for morons, sucks and costs more than its worth!

Film at eleven.

Well gee wiz, guess you shouldn't have offshored and outsourced all that software engineering to a bunch of thirdworld who-hahs?

Too bad we don't hire and use high quality American software engineers, instead of those "programmers" who work for $15/hr.

 

[Cabn12]

I work in the medical field as a Senior Technical Analyst and the clinical system we used was heavily influenced by nurses input and after several years it is still being tweaked on users needs. The nurses were overwhelmingly surprised at how easy the system was\is to use. If you can make a nurse happy that is really saying something. (anybody who works in the medical field can attest to that) there are some reports that would take three shifts to complete, with the computerized system it takes one nurse about 15 seconds. That without a doubt is cost savings.

 

[Jacflash]

Saving money was not the driver for automating business processes and patient information systems - compliance with laws and regulations was, as well as improving patient care and safety.

 

[gesicht]

i have done some IT work in the medial community and i charged them normal fee's for parts and labor and i had people just outright pay me double because they couldn't believe how cheap it was.

the few companies that work with in the medical community straight out rape the system and from what i hear give them very poor service.

i am talking charging them 400$ for a 17 inch NEC monitor, 125$ on sale for keyboard. plus install charges, warranty fee's. service contracts ect. their labor cost had 5 brackets. monday cost different then tuesday and wednesday. thursday was extra, friday and saturday was double the cost of tuesday and wednesday and if you want service on sunday or after 6pm you are paying 3x as much per hour.


i bet they dont save money because for every 700$ computer they install they charge 4000$.

the medical system is more like the mob. it is simple process but there is a bunch of systems in place so that everyone can make money off of it and the only guy that gets screwed over is the consumer.

 

[MaximVesuvius]

That is the biggest problem with most systems. The systems are not designed for the users that have to use them the most - nurses and doctors. They are stupidly complicated.

Depends on what level of systems you're talking about.

For IT/LIS, I would agree that seting up interfaces, intergration, and analyzers is a real chore and tons, TONS of hours of work that goes on forever.

But what's so hard to use these systems on the end user side? For Sunquest it's super easy and Meditech it's easier still (I don't know about Cerner or GE Centricity).

Hell, if you're a physician you don't order tests or register patients. You should have the results autofaxed/telecomed to your office. If the results are not autofaxed, then there's some EMR that's super easy to use as well (i.e. Digichart, Powerchart, GE Centricity, Emdeon's Clinician).

If you're a nurse, assistant, or accessioning; the only difficulty is what test mnemonic to order, but there's easy ways around that (i.e. test dictionaries). Researching ICD9 codes, filing ABN's and figuring out Medicare.

For medtechs, it's very technical and very difficult but that's a given.

The real pain for medical staff is the multiple software packages that require training for each, passwords for each, and then the occasional/consistent downtime.

Even then, after a few weeks. Keystrokes and mouse clicks become routine and just as simple to remember as the layout of your house.

 

[Magnus]

Saving money was not the driver for automating business processes and patient information systems - compliance with laws and regulations was, as well as improving patient care and safety.

Let's not forget the real powerhouse, risk management. The pencil necked paper pushers make me sick. The job of caring for sick people takes a back seat to regulations, policies and, protocols all in the guise of "improving patient care and safety."

Any improved patient care is purely an unintended side effect of maintaining profitability and covering their collective asses. My only consolation is that sooner or later they WILL experience the results of their own handy work.

 

[Apathy]

This is a very stupid article. I work in a hospital and I have seen a lot of pen & paper processes turn into automated computer processes since I have been at my current job.

We save so much time scanning meds, and ordering meds, and verifying meds in the computer. We used to have to hand write everything on these pieces of paper, and half the time you'd spend time trying to decipher just what the hell the doctor wrote before you had to rewrite it on the med sheets and get the orders moving along.

Now we get orders on the computer, they print out, we get the meds, scan the meds/patient with a hand scanner, and boom, done.

The problem isn't computers, it's the people using them and the poorly coded software written for the programs they use. So much redundancy and impossible menus. Not enough medical people working in IT to set anything up properly. Constantly running into problems with this or that, and it takes weeks to correct a problem or add a menu or option to a field that requires it.

Meditech is TERRIBLE.

 

[Inf0]

vendor lock-in shitware

This will be a useful addition to my vocabulary, thanks.

 

[MixManSC]

Meditech can be both good and terrible. It's an extremely modular and customizable system. If poorly implemented (and it usually is) it can be a nightmare. I think one is the larger problems aside from that is there is dozens of different systems from different vendors for doing different things requiring the working staff to know how to log into each system in different ways usually with different logins and passwords and of course all different menus and interfaces. Meditech for a lot of stuff but then they have to deal with assorted other applications like Pyxis, Spacelabs, GE, etc, etc...

 

[radioactivez0r]

Board of Directors wants a new fancy tech system for their hospital, so they assign the task to a manager. The manager knows nothing about it, so he tells a peon to start accepting bids. The company with the best pitch gets the job, even though they probably suck at what they do. They go over budget and run up the tab before half-assing an incomplete system which nobody who actually needs to use it has any clue about how to use.

I imagine there's a flip side as well, but I'm so cynical these days.