Tuesday, July 14, 2009

Can Software Save Money in Health Care?

Phillip Longman has an article Code Red in the Washington Monthly talking about how to make health care more cost effective. James Kwak provides an excellent summary of the points in the always informative "Baseline Scenario".
  1. The health care cost problem is largely caused by overtreatement.
  2. The answer is software: "Almost all experts agree that in order to begin to deal with these problems, the health care industry must step into the twenty-first century and become more computerized."
  3. Software implementation projects can go horribly, horribly wrong.
  4. The solution is open-source software.
Point one makes sense, but there is no reason to believe that software will solve this problem. If anything, software will make the problem worse. Why?

Computerization is like paving the cow path. People gather requirements, find ways to do things more efficiently and then, ideally, implement software systems to do this. i.e. they pave the cow path. So now cows move more quickly, one has more visibility to where they are and more people can interact with them in more ways. How will this reduce cost?

Someone is in a medical facility for a certain period of time. Paving the cow path will enable fifty people to interact with them as opposed to five. So now fifty people can over treat and over bill as opposed to five. And anybody believes this is going to reduce overtreatement and cost?

It's like trying to trap a mouse in a house of cheese.

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