For the full text of this article you are referred to The Economist newspaper of February 28th of this year. Alternatively the text is accessible on The Economist's fine Web site Medical Industry Slow To Exploit Information Technology
In theory, information technology could help doctors, hospitals and insurers to deliver better care for less cash. In practice, however, such savings have been slow to appear. There have been sins of omission in hospitals, which have turned their backs on computers. There have also been sins of commission at health-maintenance organisations…. All have tried to go digital, but most have botched it.
HMOs may have been ineffectual in their exploitation of IT; but the rest of the health-care industry has barely begun even to grasp its possibilities. The knowhow currently exists to allow doctors to supervise operations from thousands of miles away, to send X-rays and CAT scans back and forth electronically, and to keep both themselves and their patients abreast of the latest medical discoveries via the Internet. All these technologies could speed up and reduce the cost of treatment. Yet, as anyone who has visited a hospital recently will know, they are hardly ever used. Unlike, say, bankers, medics are woefully unwired. Most still write out prescriptions and bills by hand.
Perhaps the clearest example of a medical technology whose time ought to have come but hasn't is telemedicine. Suppose, for example, a patient is given an X-ray at his local clinic. The chances are that there will not be a qualified radiologist available to interpret the results. Either the images must be posted to the nearest large hospital, or a specialist must drive to the clinic to look at them. If, however, the images are sent electronically, the radiologist need not waste costly time travelling. A study of just such a scheme at the University Hospital of Tromso in Norway found that each participating doctor saved 5-6 hours a week. Patients receive their diagnoses more quickly and just as accurately as they did when somebody came to visit. Despite these advantages, only one radiograph in 1,000 is examined by a distant specialist.
Another sensible but neglected application for telemedicine is in home health-care. Many old people need frequent check-ups but are too frail to travel, and so are visited once or twice a week in their own houses. A typical visit costs about $90 in America. This can be cut to $15-25 if the check-up is done remotely, using equipment that costs about $1,000. Since televisits cost less, they can be made more often, cutting hospitalisation rates by a third and the length of an average hospital stay by a day ….A survey by Telemedicine Today, a trade magazine, found that fewer than one visit in 2,000 is made electronically…
Like many new technologies, telemedicine is hindered by laws framed before it was invented…
A further road-block is finance. Medicare and Medicaid, the public programmes that account for two-fifths of American health spending, have grudgingly started reimbursing doctors for teleradiology, but refuse to cover telehome-health. Private insurers have tended to follow this lead. This is an absurdity…
Telemedicine has blossomed only in niche markets where these problems do not apply. In the American army, for example, a vast communications infrastructure is already in place, legal niceties are irrelevant and the budget for saving soldiers' lives is practically unlimited. In American prisons, too, telemedicine is favoured because it eliminates the security costs of transporting sick criminals to a clinic. And rich patients from poor countries, where highly qualified doctors are scarce, are increasingly likely to opt for a remote consultation…
Depressingly, the slow adoption of new technology in HMOs and hospitals is perhaps only to be expected. Doctors are often so busy trying to keep up with new discoveries about drugs and diseases that they feel they have no time to learn how to use computers as well. The new systems are hard to install and exploit. It was ever thus. The Times reported in 1834 that the medical profession was unlikely ever to start using the stethoscope, "because its beneficial application requires much time and gives a good bit of trouble."
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