Roger D. Jones, PhD
November 23, 2012
I would like to start this blog with a story about my college-age daughter. Like most college students, she likes pizza. Beth, because she is a modern child completely comfortable in the information age, orders her pizza over the internet. She can monitor the progress of her pizza online. She knows when the cheese has been applied and also the pepperoni. She knows when the pizza has been placed in the delivery car, and she knows, within a few seconds, when the deliveryman will knock on our door. She also knows the deliveryman’s name.
Let me contrast this with another personal anecdote. My mother, while living at home some distance from where I live, had a chronic and potentially lethal bowel infection. She had an incident in which she needed to go to the emergency department. The emergency doctor, who had no health records for my mother and who did not consult her primary-care physician, diagnosed her as having a rotovirus and sent her home. Two days later, she was admitted to the hospital with the serious bowel infection for which she was being treated by her principle-care physician and that had nothing to do with a rotovirus. She remained in the hospital for several weeks and had near-death experiences. Her life was saved by the skill her physicians and high-technology expensive procedures.
A few weeks after her return home, she had a recurrence of the infection and went again to the emergency department where the same emergency doctor once again diagnosed her as having a retrovirus. Once again she was sent home, and once again she was later readmitted to the hospital and treated for bowel infection. This time she came much closer to death. At one point, I was told she would not live through the night. After another heroic and expensive life-saving procedure, she did live. After a few weeks in the hospital and rehabilitation, I admitted her into an assisted-living facility.
My mother has not had a recurrence of her infection in the two years she has been in the assisted living facility. She has gained weight and is, in general, in good health for someone her age. The reason her health has improved is because, now, her health information is being better managed. A nurse has complete knowledge of her medical conditions and vital signs. Her medication is properly administered. Her doctors’ appointments are coordinated. In my mother’s case, there were dramatic and expensive technological procedures that saved her life, but her life would not have been threatened in the first place had her healthcare information been readily available to her healthcare providers. While her entire assisted-living package is expensive, it is much less expensive than the life-extending procedures she underwent because her health information was not being properly managed. The information-management systems are simply not yet in place in large areas of healthcare.
There may be many reasons why modern information management has not yet made it into US healthcare: privacy concerns; size of the problem; physician and hospital compensation designed around procedures rather than outcomes; the emphasis of healthcare training programs; and political issues. The population has, however, made online information management an essential component of the modern lifestyle. While healthcare information management may not be as easy as pizza pie, Americans are prepped and ready for it.