A holiday reminder of the dismal state of Healthcare IT

I’m home in the Bay Area for thanksgiving with the fam’, which means my attempts to work from my old bedroom are periodically punctuated by that most classic of family rituals – driving my mom around to run errands.

Thus, I find myself tapping this out on my iPhone as I find myself stuck for the n-th time waiting FOREVER at a pharmacy as some mystifying process glitch has thrown the normally “well-oiled” @Walgreens machine into befuddled disarray.

You see, the Walgreens system can’t seem to figure out that my mother has actually been prescribed one of the medicines she’s getting a refill of. Or that a second refill has been authorized, even though she handed them a physical prescription slip yesterday. One suspects that dealing with such nonsense takes up a substantial portion of at least one of these pharmacists day.

Now let’s imagine a different world. A better world.

You walk into your doctor’s office, complaining of a sore throat and unsightly discharge. The doctor presses a button, and up comes your entire health history, including all the medicines you’ve ever taken and all the procedures you’ve had. She enters your symptoms, and an “expert system” like IBM’s Watson automatically checks data published by the Center for Disease Control and prepares a report showing the empirical probability you have various diseases given your symptoms and history, and proposes the most effective tests to narrow down the options. As a bonus, the system checks your personal genetic information to identify the ideal diagnosis and treatment.

The doctor appraises the automated results and decides that you must have…let’s just say…Lupus (in the spirit of House, MD). This can be easily treated with a few pills of Silver&Garliceral. The doctor presses a button, and the system, which has your address and insurance information, automatically connects with the nearest pharmacy to put in a prescription authorization. The pharmacy system automatically estimates the wait time, and sends you a text when your prescription is ready, or if it’s not urgently needed (which it knows based on the disease it’s prescribed for), just mails it to you.

This world saves a massive amount of time both for patients and administrators, and also substantially reduces the risk that patients will get the wrong medicine, or the wrong dose, or simply neglect to pick up their prescription at all.

And here’s the thing – the world I describe is not fantasy. We could do all of the things I describe just by cobbling together existing technology. In a world where healthcare costs are constantly rising faster than inflation, fixing this completely fixable mess (by fighting the institutional dynamics / inertia that allow it to continue) seems like a great place to start.

Forgive typos…I literally wrote this on my iPhone.

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