Change Now or Wait for Natural Evolution?

People are not usually anxious to embrace change, that is, unless the existing situation has become so uncomfortable that they imagine things can only get better.

Healthcare providers who want to adopt electronic health records into paper-based practices are finding themselves in that predicament. Unless things are terribly unworkable right now, staff and physicians might not think that another way of doing business will measurably improve the status quo. Add to that resistance the fact that the change is virtually mandated by the government, will cost money and disrupt workflow, and you can end up with a lot of unhappy campers during an IT implementation. Unless, somehow, the providers and staff believe that electronic patient records will improve the current situation.

Electronic patient records could make patient care better, and done well, will certainly address lots of problems with accuracy, availability and useability of patient information. We all know that is possible.

We also know that in their current form, some electronic patient record systems implementations are falling short of the goals of ease of use, workflow improvement, faster claims submission and fulfillment, more accurate patient data resulting in higher quality care, etc. Studies have even shown that, when fully functional, electronic patient records will save money for the individual providers and the entire system, meaning there should be a trickle-down effect in price containment.

No, we aren’t even close to there yet. But we are getting closer everyday.

The government has implemented mandates, incentives, deadlines and processes to advance the pace of the uptake and interoperability of health IT. The official effort pushed down from the top is a catalyst to advance the process ahead of its natural pace. And that assumes there would be a natural pace of the eventual adoption of electronic patient record systems resulting in a national database of patient information for care and research.

Because information technology and the Internet, in particular, dominate our world, it is more than likely – almost certain – that over time we will achieve full uptake, integration and interoperability of electronic patient records, and all the efficiencies that other industries have already realized. And this would probably happen even without government influence.

Knowing the inevitability of information technology for healthcare, the only question left is whether we push through the change now – at the massive cost and effort involved in the push – or we wait for the natural evolutionary pull to occur. For those who advocate pushing through the change now, we’ll need to prepare the way for a whole group of healthcare workers who might not – yet – be convinced that the current state of affairs is undesirable.


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