Texting while driving is so dangerous that it's outlawed. But doctors and nurses are expected to care for patients while keeping their eyes glued to a computer screen, following prompts and clicking boxes. Some electronic health record systems require 62 clicks just to order Tylenol, and a full emergency room shift involves 4,000 computer clicks. No wonder mistakes are rampant.
Last week, Food and Drug Administration Commissioner Scott Gottlieb pointed to "risk for patients" due to poorly designed electronic health record systems. Children can face overdoses when medication orders are entered incorrectly; patients have had cancers that weren't diagnosed because their scans were routed to the wrong file; and even one emergency room patient suffered a collapsed lung because medical staff struggled to access her health information.
Going digital was a good idea, but Washington hubris turned it into a costly mess. President-elect Barack Obama, the health care transformer, announced in 2009 that he'd make sure "all of America's medical records are computerized" within five years. Only a handful of hospitals and 17 percent of doctor's offices used them at the time.
Government force was employed to make the change happen with lightning speed. The Obama administration proposed the American Recovery and Reinvestment Act of 2009, which slapped hefty financial penalties on doctors and hospitals that didn't comply starting in 2015.
"It's not that we're a bunch of Luddites who don't know how to use technology," said one ER physician from Rhode Island. Doctors were forced to install systems fast, without a clue about which ones actually worked. "There really wasn't the time to let the cream rise to the top; everyone had to jump in and pick something that worked," the physician added.
Medical organizations such as Docs 4 Patient Care Foundation warned that new technologies can have unexpected side effects and doctors and hospitals needed more time to adapt to new systems. But the Obama administration pushed ahead, insisting it was an emergency.
Information technology vendors, including major donors to the Obama campaign, rushed to cash in.
Ten years later, here's the wreckage. It comes with a warning not to allow radical health reformers, including today's advocates for "Medicare For All," to insist on sweeping overnight changes. Patients pay the price.
Incompatible Networks: Taxpayers spent at least $26 billion from 2009 to 2014 on electronic health record systems but got a patchwork of ones that don't communicate. If you're in a car accident far from home, the ER doctors don't have your medical records.
Cookie-Cutter Care: Obama's high-tech guru Dr. David Blumenthal wanted top-down control of the treatment decisions doctors make. Doctors have to follow computer prompts or be punished financially with lower Medicare payments. Blumenthal predicted doctors would resist the loss of autonomy, but he also believed it would result in better care, more savings and fewer unnecessary tests and treatments.
He was right about doctors resisting it but wrong about everything else.
Stanford University School of Medicine researchers examined hospital records from six states, including New York and California, finding that hospitals complying with the electronic records mandate have similar, not better, patient outcomes or survival rates.
Electronic programs evaluating when physicians should prescribe statin drugs are "highly prone to errors when measuring provider performance," according to a research report by Emory Clinic.
Cardiologist Jeffrey Borer warns that atypical patients who don't fit the protocol lose out.
Doctor Burnout: They're furious about being turned into "unhappy data-entry clerks," says Dr. Robert Wachter of the University of California, San Francisco. Burnout is becoming a major cause of doctors abandoning the profession according to an Annals of Internal Medicine editorial.
Dangerous Errors: Getting rid of doctors' illegible scrawls eliminates some medical mistakes but may lead to others. One-third of pediatric patient safety problems were linked to electronic medical records, according to a 2018 issue of Health Affairs.
Unhappy Patients: They yearn for eye contact with their doctor and are pestered with computer-generated questions unrelated to why they came in.
Fixing this mess isn't like tossing a defective toaster and getting a new one. Some major health care organizations have spent more than $150 million apiece on these systems -- and starting over is costly.
The lesson seems to be lost on Washington's newest wave of health radicals. They want to abolish private insurers, eliminate employer-provided coverage and trust the federal government into providing better care for less with Medicare For All. Beware their hubris. We've been hurt by it before.
Betsy McCaughey is a former lieutenant governor of New York State. Contact her at firstname.lastname@example.org.