Living in a Retro Health Care System

by Kim Bellard, January 26, 2017

Living in the 21st century is cool, right?  We've got smartphones, ultra-thin tablets, the Internet, wearables, Uber, self-driving cars, virtual/augmented reality, drones, digital currency, and all the TV/movies/music you could want available for streaming anytime, anywhere.  It makes Back to the Future II's 2015 look drab by comparison (except maybe for the hoverboards!).   

So why does it seem like so many people are entranced with the 1980's?

Take, for example, the resurgence of vinyl. Vinyl is back, set to become a billion dollar industry (again).  

People are falling in love with cassette tapes again.  Their sales rose 74% in 2016. People are even inventing new ways to listen to old formats.  The Verge reports on Love, "the first intelligent turntable.”  

Retro isn't confined to music.  One of the hottest Christmas presents was the Nintendo NES Classic. Hey, we've got the Today show doing a 1970 retro show, the NFL going crazy with throwback uniforms, and the predicted reemergence of flip phones.  People even want retro computers.  

If any industry would keep its eye relentlessly on the future, you might expect it would be health care.  Few of us would want to go back to what health care was like in the 1980's, and none of us would accept the health care of the 1950's (except maybe those house calls).  

No, in health care we expect the kind of futuristic -- or, at least, modern -- experience that tech-based start-ups are promising.  If health care went retro, why, we'd usually make appointments to see our doctors in their offices instead of seeing them on-demand 24/7, wait long periods in their bland waiting rooms, fill out lots of paperwork, have our white-coated doctor listen to us with their stethoscope, have lots of unnecessary or even harmful tests and procedures, even have our information sent by fax.  No one would want to go back to all that.

Oh, wait -- that is our health care system, for the most part.  It hasn't gone retro because we haven't yet moved past retro.  

Get this: fax machines remain the predominant form of communication in health care, with fax volume hitting new records.  That's not retro, that is insanity.  

Get this: physicians hate their EHRs so much that they are cited as a leading reason for physician burnout, and in their frustration with them physicians are turning to medical scribes to do the inputting.  

Get this: after seeing a consumer revolt in the 1990's against managed care's capitation, small provider networks, and restrictive medical management, they're all back in vogue, in one form or another.

I get retro.  But I do not want to get care in a retro health care system.  

EHRs are a perfect example of how we took something that should revolutionize health care, and turned it into something that not only no one is happy with but that many feel often impedes care, to the point some want to go back to paper records.  We didn't do the wrong thing with EHRs, we just are doing it wrong.

We should be thinking big and bold about how we want our health care system to work in the 21st century.   We should be looking forward, not backward. We have all the technology we need to make our health care experience, well, if not like magic, then certainly more like a 21st century health care should seem.  Let's get there first -- then maybe we can think about how we can do some cute retro to it.  

This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting