“The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age.” Robert Wachter MD. McGraw-Hill. New York. 2015. 330pp.
It shouldn’t take much to convince neurosurgeons that our conversion from paper to digital has been a disaster. Robert M. Wachter, MD, father of the hospitalist movement, documents how health care has fallen on its face trying to make this transfer. I can remember spending $350,000 in 1999 and thinking that our office had made the transition, but now appreciating that 16-years later, we are still in the process of transition.
Dr. Wachter tells a good story. There is plenty of blame to go around. It is still amazing that this transition has been so unsafe, unreliable, unsatisfying, frightening and impossibly expensive; and he has a good argument to support each of those claims. He details the problems of faulty software, implementation failures and absurd regulations.
A quote from the book will whet your appetite: “While our Electronic Health Records (EHRs) will contain vast amounts of information, big-data techniques may be no better at sifting through bloated copy-and-paste-ridden notes than are the frustrated doctors trying to do so today. Much of the data in EHRs continues to be collected for the purpose of creating a superior bill, and using this waste product of administrative functions for clinical decision making can lead to a GIGO (garbage in, garbage out) problem, even with fabulous analytics.”
This book includes the story of how Epic became the most successful company in hospital information technology and how athenahealth has developed into a hot web-based service for keeping medical records for doctors. The Health Information Technology for Economic and Clinical Health (HITECH) Act, as part of the Affordable Care Act (ACA), has changed the world. However, Dr. Wachter is very doubtful that the Meaningful Use program is going to work.
In spite of the myriad catastrophes that are well documented, Dr. Wachter remains the eternal optimist. He believes that the $30 billion that Obamacare has thrown at the problem will save the day. He thinks that the worst is over and a new day is dawning. Part six of the book includes three chapters on a glorious future. This part of the book describes what heath care can be with all of the marvels of a high-tech digital world. These last three chapters are the ones I will tell my medical students about. Dr. Wachter’s view of the future of digital health care may make the spending of the $30 to buy this book worthwhile.
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