Why Tech Can't Cure Medical Inflation

Why Tech Can't Cure Medical Inflation

Lee Gomes, 12.18.08, 06:00 PM EST
Forbes Magazine dated January 12, 2009

Computers in medicine aren't a cure. They might even make the system sicker.

Whenever President-elect Obama is asked how he'll pay for his ambitious health care reform plans, he invariably talks about the $80 billion in annual savings he'll get from bringing computerized recordkeeping to doctors' offices and hospitals.

If only that were true. While there are benefits that might be had from using computers more widely in medicine, doing so won't save us any money and, in fact, will likely make things more expensive. There's even a chance that the quality of care might get worse along the way.

That's probably counterintuitive to anyone contemplating the wall of file drawers in a typical doctor's office. Medicine clearly has yet to join the rest of the world in going digital; no wonder, the thought goes, that U.S. health care is so expensive.

But while paper records certainly have their inconveniences--filling out your thousandth questionnaire, say--they play a very minor role in galloping health care inflation.

Instead, the heart of the problem is the U.S. fee-for-service system, in which doctors get paid to do things to people. The more technical and invasive the procedure, the more money they make. Doctors have responded in the expected Pavlovian manner, collectively shifting away from basic primary care toward expensive specializations that run up costs without necessarily improving medical outcomes.

As any chief information officer can tell you, adding computers to this sort of inefficient process only makes the inefficiency happen more quickly.

Much of what doctors or policymakers know about technology comes from vendors, who are busy guilt-tripping the medical sector about being slow to get with it. But more quietly, health care economists have been studying the actual impact of these systems. Their findings should disturb those who look to information technology for an easy fix.