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The tough choices facing health care

Madison, Wis. — Much of Thursday's Digital Healthcare Conference in Madison was about choices. Health-care professionals are facing plenty of them.

In today's issue, the first of our two-part series on the issues arising from the Digital Healthcare Conference, you'll read about the technology choices Wisconsin health organizations face, and how they are approaching those choices. Next issue, look for coverage of the double challenges of liability and public scrutiny.

The rising star of health-care technology is now the electronic health record, a computerized data bank of past conditions, test results and treatment plans accessible from anywhere.

"Anywhere" is simultaneously a solution and a problem.

It's a solution to the dead weight of paper records that can't be quickly found and transferred when an emergency happens, especially away from a patient's home clinic. And it's a problem because medical information is surely one of a person's most private records.
Physicians also worry about dumping onto patients the raw data that is normally interpreted by experts. Will they be smart, prudent and knowledgable enough to do the right thing?

"We are sharing health and health managemnet with laypeople and we have to provide tools to allow that to happen," warned professor Patti Brennan, the director of HeartCare, a University of Wisconsin-Madison study of how online communications and status reports can help cardiac patients recover faster in their homes.

All this and more in our coverage of the barriers to the electronic health record.

More tough choices

While they're trying to bring electronic health records into play, of course, IT departments still have to worry about the big picture, and all the other technologies that keep modern health-care running.

That means making tough choices and dealing with integration hassles, not just between different technologies but between the technology and the people who use it.

Repeatedly, Digital Healthcare Conference presenters warned against expecting better computer systems to fix everything, especially when it's the basic operational processes that need to be fixed.

"If you have one death per 10,000 admissions in your hospital, your hospital is doing exacty what it was designed to do," said Barry Chaiken, associate chief medical officer of BearingPoint. "If you use clinical information technology tools, with those processes, you will improve your results and you will kill three people per 10,000, because you will do those bad processes that limit the ability to do good care ... you'll only do them better than you've ever done them before."

With that warning in mind, read about how hospitals and other health-care providers are approaching choices about technology adoption.

Up next: Anyone in health care is used to dealing with situations and events that are not completely under their control, but from their own systems? Later this week, you'll learn how the health-care industry is facing new liability questions as computers make more of the decisions.

Meanwhile, hospitals turn to war – war games, that is. In our next issue the former CIO of the U.S. Department of Health and Human Services and the FDA will share a way to make hospital staff more comfortable dealing with disaster by putting them in the hot seat for a while. After dealing with a flurry of media inquiries, anxious family members and other simulated scenarios, the real thing should look a little more manageable.

Now, read on for this week's stories:

Electronic health records

Tough technology choices

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