Healthcare 'Consumerization' Could Drive EMR Adoption

In an opening keynote at Everything Channel's Healthcare IT Summit, "The Once and Future Health Care Information Revolution," J.D. Kleinke, medical economist and author of "OxyMorons, The Myth of a U.S. Healthcare System," said that fundamental structural problems in the health-care industry that have forced health-care plans to offer substandard care will be addressed by the inevitable 'consumerization' of health care, driven by the abundance and accessibility of health-care information on the Internet.

"This is the situation that we're in. The rock is that we want everything. The hard place is that we want it all to be free," Kleinke said Sunday to about 300 medical and health-care IT professionals attending the event.

Kleinke said that up until now, those fundamental systemic flaws have, among other things, led to substandard care, driven up costs and prevented providers from making EMRs widely available to users and accommodating other patient demands. Kleinke noted the "love triangle" between the patients, the providers and the health plans has fueled a prisoners' dilemma.

"Health care is a love triangle. They don't work very well. They are full of mistrust; you have two against one," he said. "They realize it's dysfunctional to kick sick people out. It doesn't feel good. Nobody wants to do that. Unfortunately, if the other guy does it, you got to do it too. It's a prisoners' dilemma."

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"And it is bad for their business when they do that," he added.

Kleinke said that 80 percent of the public wants doctors to use e-mail but only 9 percent even do so even occasionally. "Health-care IT problems -- they are health-care problems; they are system problems," he said. "It takes years to implement that stuff and we're still so far behind as an industry."

Kleinke said that current technological trends, aided by an evolving political environment, could finally "fix the gaming of the system" that has forced health plans to do the "wrong thing," he said.

Now, more than ever, users are regarding health care as a commodity, in which they have the increased ability to choose health care and health care providers that best fit their needs for the lowest price. That trend might ultimately increase competition and force providers to offer EMRs, as well as other services, as they fight for customers' business, Kleinke said.

"We get so wrapped up in the EMR, the culture of the EMR -- all that stuff is all true, but the bigger question is, 'Why?' 'Why bother', 'Why build?'" he said. "The real reason is everyone in this room now is in the consumer business, and consumers are making the choices, especially in Medicare now."

Major health-care provider Kaiser is already offering patients EMRs and the opportunity to communicate with their physicians via e-mail. Subsequently, Kleinke said, it was just a matter of time before EMRs become ubiquitous in the industry.

"The horse is out of the barn and it's a market that's screaming to happen," he said. "This is the end game for the love triangle. It's the end game because that's what people want."