Let’s face it …convincing practicing healthcare professionals to document health data on a computer is daunting, to say the least, In India, most physicians feel that documentation is not a part of their job profile, but consider the fact that the entire process of history taking and case sheet writing is a process of documentation. Most physicians have been “doctored” to use a paper to document their findings, and that too in a specific standardized format. So what makes this physician community reluctant to adopt a new methodology.
A certain realization has dawned over the years, though there are certain pros and cons with either of the formats viz paper-based documentation and digital documentation. Paper-based documentation is more ingrained in the most current generation of practitioners and hence appears to be the officious default setting that doctors adopt, lean, and depend on.
Needless to say, paper documentation is handy … as the most would’ve you believe it, but it is not because of hands being always at hand…that makes paper documentation handy. Rather the ubiquitous availability of paper pads. Additionally, as the current breed of physicians is all schooled to write on paper since kindergarten, the task appears easy and convenient. However, as we all know from our colleague’s prescriptions and case sheets, most paper-based documents are bulky, clumsy, and difficult to decipher by other physicians. Moreover, like the ballpoint pens, papers tend to get lost in another unknown dimension.
All the above arguments make a good case for digital documentation; however, most physicians appear to be technology resistant to adopt it. I have deliberately used the word “appear” because it does seem to be an appearance of technology resistance, as most physicians are eager to adopt technology when it comes to procedures which increase their revenue potential or patient outcomes. Admitted, acceptance of technology procedures and interventions trumps mundane documentation any day. Moreover, documentation does not yield any tangible benefits to the hospital, patient, or physician.
We all agree in the long run, digital documentation is the way to go and that the benefits are numerous; however, benefits are not tangible, hence not really a driving force for healthcare establishments to implement. This quandary begs the real question as to whom is it important…who benefits tangibly from the digitization of healthy records, after considerable flapping of the idea around in my brain, I have come to certain conclusions.
Firstly, documentation is central to insurance agencies for claims processing since the entire industry relies on documents and their interpretation; they are the primary tangible beneficiaries. Secondly, there are high-volume institutions who rely on documentation and statistics to analyze and allocate resources in a large scale. The institutions that come under this category are the government or any such large bodies/organizations which involve a large number of people who constitute the beneficiaries.
In conclusion, there are no physicians or patients in the picture. That is not to say that they are not the beneficiaries of the digitization process. It is just that the benefits are not tangible, hence the lack of appreciation or adoption of such measures and practices…in essence, they would
“like” to have them ..but they would not “want” to have them. So in the process, we have at least identified which cat to bell. The insurance sector primarily holds control over the documentation process within all private-run hospitals, and all hospitals submit meekly to their diktats.
The insurance sector is a private-run sector, and thus digitization would be made enabled in hospitals, albeit a little arm twisting is required. The approach is fragmented at best since not all institutions subscribe to a single insurance provider. Moreover, there are many insurance agencies that have their own software to analyze data. Insurance companies are not a cohesive entity as there are numerous companies with a mind-numbing array of policies. As they compete with each other and arm-twist the healthcare establishments, they really do not have a long-term plan or goal to bring in some universal health data acquisition methodology to analyze claims.
They operate on both sides of the shores with private hospitals as well as with other government entities and end up being flanked by these well-entrenched establishments resisting to give way to radical improvisations. Thus the insurance companies, too in the run-up to their survival are confined to a natural middle course to survive and move forward.
So it is a battle of the insurance, and they are fighting the lone war in digitization, rest are reluctant spectators of digitization. Some adopt its novelty, others for the “future promise” it holds. How do we get everyone to bite this digitization bullet who fires it …what is the target?
The answer seems to point toward a metaphorical bullet that pierces the existing layers of numerous establishments, which brings these entities to their knees, coercing them into action to adopt a digitization policy. Government-mandated legislation is the only sure-fire way to ensure everyone falls in line. The legislation ensures that all health establishments, private /government, adopt policies to digitize and maintain a universal repository in the long run. I am aware that it is easier said than done…at least legislation would fire the first salvo…
Read More: Information Technology In Healthcare.
