Wednesday, February 17, 2010
The Cleveland Clinic
The Cleveland Clinic is being touted as the model for American health care reform, and that’s fine. What the Cleveland Clinic has done is to discover the benefits of Fluxus Quo in developing their own medical records. President Obama wants to spend $45 billion of stimulus money to “export” Cleveland’s system to other hospitals around the nation. While promoting electronic medical records is a good thing, there are some real hurtles the President needs to be aware of.
1. Electronic medical records are not plug-n-play. The Cleveland Clinic, like the VA, has spent decades and millions of dollars getting there system where it is today. Dr. Martin Harris, who oversaw the Cleveland Clinic install states, “If you install the entire electronic medical record on day one, that can be a very dangerous model.” (Schwartz, Lagan, & Sieck, 2009)
2. Electronic medical records are not cheap. Cleveland Clinic had pockets deep enough, and determination strong enough to keep pursuing their dream through hundreds of millions of dollars; and it takes additional millions of dollars each year to keep improving and innovating the system.
3. Electronic medical records are not easy. Doctors and staff alike have to go through an enormous “learning curve” before they understand how to efficiently and effectively use the record to the patient’s advantage.
Given these faults, there are distinct advantages to EMR’s:
1. They do eliminate mistakes. In the first year the VA installed the Bar Code Medication Administration module of their medical record, medication errors virtually disappeared. We are not talking about a sharp drop; we are talking almost completely eradicated.
2. The do streamline and safeguard records. During the evacuation of the VA Hospital in New Orleans leading up to Hurricane Katrina, the patients were, for the most part, evacuated to the VA Hospital in Houston. Their medical records arrived in Houston ahead of them being transmitted over the VA network.
3. They do make health care better. The best diagnosis begins with the best information©-2003 HITS, Inc. is not only a saying, but a fact.
Given all this, how do we require hospitals to have an up-and-running EMR within the next five years? Realistically, you do not. You can require them to show evidence of their planning and programming for an electronic medical record, but you cannot take neither the VA system, nor the Cleveland System and export it to another hospital. There is a saying within the VA that goes, “When you have been to one VA hospital, you have been to one VA hospital.” That is not a criticism for lack of organization, but praise for the VA’s ability to flex and bent to better serve their patient population. Medicine changes to fast to use a Status Quo model of software or technology. We had better learn the lessons of Fluxus Quo, and learn them quickly.
Works Cited
Schwartz, E., Lagan, S., & Sieck, S. (2009, December 1). Video: How The Cleveland Clinic Went Digital. Cleveland, Ohio, USA.
