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I work in the medtech/health IT field at a startup doing a lot of clinical analytics. There's a very blunt and obvious explanation of what's wrong here, and it'
by angersock 12y ago
I work in the medtech/health IT field at a startup doing a lot of clinical analytics. There's a very blunt and obvious explanation of what's wrong here, and it's the very unpolitical one.
Here's the deal. Physicians and nurses and administrators are overworked and untrained to handle a modern operational model. The hospitals tend to be based around politics rather than patient care, though the party line is invariably "help the patient". Doctors will, under the aegis of "help the patient", justify hoarding equipment, setting up alarm thresholds that screw up operations across the unit, block acquisitions, and in general just make everything terrible left to their own devices.
Nurses are overworked and are charged with increasingly important parts of patient care, and at the same time are treated as annoying appendages of the rest of the medical apparatus and not given the respect or authority that they require to perform well at their jobs.
Billing is handled through arcane back-and-forths between the care providers themselves, the hospitals, insurance companies, the government, and collections agencies. I've seen at least one local children's hospital (the economics of such institutions are quite fascinating) have banking and financing services occupying the same building as care (something you'd expect at a car lot, not a place where injured children are healed). Claims may take months or years to process, which is absurd.
The whole stinking mess should have been grist for the capitalist grinder decades ago. However, clever regulatory capture by hospitals and manufacturers and labor policies restricting the supply of new physicians has managed to prevent any of the normal efficiencies from being introduced.
When trying to introduce new technology, you have to fight the most conservative and risk-averse institutions you'll ever encounter. People that do not understand basic statistics or mathematics, or that flat out refuse to recognize the value of operational data research in making decisions because "they know better". You'll be turned away because you're not one of the chosen few, and ignored unless you can convince them that they get to put their name on the new shiny.
This is but the first level of the fractal of sadness and absurdity that is modern medicine in America.
- ddw 12y agoSpot on. And then you get the pessimistic doctor that says you're trying to ruin "the art of medicine."
- bsder 12y ago> I work in the medtech/health IT field at a startup doing a lot of clinical analytics. There's a very blunt and obvious explanation of what's wrong here, and it's the very unpolitical one. Actually, it's very political--it's the AMA--the American Medical Association. The doctors are fighting the automation of their jobs tooth and nail because once we have data we can see that ... gee ... most of them suck. Nurses could do their job ... better.
- angersock 12y agoI rather meant to explain that the problems--and their implied solutions--are not politically viable, mainly because of what you've mentioned. :)
- refurb 12y agoI think your take is remarkably accurate. I have a good friend who works at a world-renoun hospital in the US and the stories he tells! Politics rules decision making in the hospital. Leadership (including the docs) are constantly clamouring for more power. Normal market forces that would normally incentivize efficiency are no match at all.
- siculars 12y agoSeconded. I may or may not have left a similar medtech job but this job may or may not have been in the belly of the beast.... a very well known teaching hospital. Politics may or may not have run rampant and the leaders charged with modernizing the organization may or may not have appreciated technology or may or may not have known enough to support those who did. Oh well.
- HillRat 12y agoAs I told a developer earlier this week, trying to disrupt healthcare is like starting an avalanche by tossing pebbles at a boulder. Between institutions, carriers, and the godawful state of interoperability technologies (I've been on the standards committees, I accept my share of the blame), it's essentially impossible to really advance the state of the art, even though there's a real need for technology that helps enable the organizational advances in clinical practice we've seen over the past several years.