This evening I am in a writing mood and just couldn’t resist commenting on their post. One of the things a blog does is allow me to post my thoughts where friends and colleagues will see them rather than scattering them on fence posts, at the base of trees, and fireplugs around the neighborhood. Comments that would have been scattered at the end of other peoples’ posts just a year ago now go here on my blog.
The three authors of part one, Katz, Saran, and Wool have done a nice job of capturing the current uncertainty surrounding EMRs and the much broader topic of healthcare information technology. Today’s market is badly fractured and still poorly defined. Having said that, I thought it would be fun to take a stand today and look back next week or two years from now and just see how much progress we have made and the direction we have taken.
For what it is worth, my best estimate is that connectivity will be via the Internet with significantly more security at all levels. The primary new employment market will probably be security because is it so critical and the threats will shift as the defenses improve. Block the bad guys here and they will move over there and we have to develop new blocking mechanisms. Then they move again. Security is always more of a process than a project.
Data will be stored using existing technology, both software such as SQL and evolving storage media including virtualized systems and clouds. More people will be needed but the skills will be extension of current skills. At lot of today’s designers, programmers, data base administrators, etc., will use the skills they have to move up. There will probably be a big market back-filling jobs in other industries were incumbents have left to go into healthcare. These will be real jobs, just not in healthcare and they may not qualify for government assistance.
Data acquisition – how the data is captured – will be the place where we see the greatest change. The work-load impact of capturing the information is one of the biggest complaints about most EMRs. There will be new technologies and significant improvement in existing data acquisition technologies. And perhaps equally important, larger markets for these new and improved technologies will bring down costs. Almost all of this will happen in industries outside of healthcare. Healthcare will be buyers, not participants.
There appear to be huge training needs to help almost everyone involved in healthcare learn to use the new tools. Fortunately there a lot of people who are already familiar with computers, office applications, and the Internet. We are not starting from square one. Flip side, most of them know very little about security, the place where I began these comments.
Bill Crounse, MD, Microsoft’s worldwide health senior director addressed this broader training need in a blog post dated October 7, 2009. “Dr. David Blumenthal (National Coordinator for Health Information Technology) has announced a ‘workforce training initiative’ to educate more health information management professionals with expertise in electronic health records and related technologies. He says at least 50,000 new jobs are needed in the field. I would add, based on what I’ve experienced, that we will also need training for perhaps ten or twenty times that number of people; i.e. most of the physicians, nurses and other clinicians who are currently practicing in offices, clinics and hospitals all over America.
“It’s not that these folks have their heads in the sand. Most of them are working so hard day to day in patient care, trying to stay afloat and keep their practices from going under, that they literally don’t have time to come up for air. So what happens when we expect them to use all of this technology and also give 45 million more people access to their services? That is going to call for one hell of a training program!