On iPads, EHR, etc.

Last updated on: December 26, 2013 at 10:56 pm by Jane the Actuary

On iPads, EHR, etc. 2013-12-26T22:56:00-06:00 Jane the Actuary

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Every now and again, I take a look at the “Legal Insurrection” blog by William Jacobson. Yesterday he linked to a Washington Post story on electronic health records, a story whose basic outlines I’d heard before, that electronic records are making things worse for small providers who don’t have the capital to upgrade their systems, and are, generally speaking, handicapping healthcare providers in general, who spend more time filling out the electronic forms than seeing patients, with endless checkboxes and fairly “dumb” systems which, as the linked article describes, require a physician to update a patient’s smoker status at each visit, even for an 80 year-old.

I’ve read similar complaints before, and claims that such forms worsen healthcare because doctors mindlessly check one checkbox after the next rather than being able to readily document what actually transpired at the visit. And, of course, I’m sympathetic — but doctors lamenting their paperwork is nothing new. What I can readily believe is that the electronic systems are not entirely ready for primetime and the essentially-mandatory universal implementation is premature. There are also clearly instances in which such records are valuable, especially when checklists of treatment expectations (e.g., for diabetes, for instance) are integrated into the recording process, and others where they’re not particularly useful, such as the unique circumstances of an elderly patient in which the particular social/familial situation (e.g., wife caring for a patient with dementia) is of more significance than any symptoms or treatments that can be identified with numerical labels (e.g., we can’t quantify the degree of impairment with a numerical measure).

What this reminds me of is the rush to implement iPads in the classroom or rather, not just in the classroom for particular learning exercises, but in a “everyone gets an iPad to take home” approach. One of the Catholic high schools sending us information this year (as my oldest is an 8th grader in a parochial school) boasts of its “every student gets an iPad” program (which, considering that the school is fully supported by tuition, essentially means, “every parent buys an iPad for their kid”), and, so far as I can tell, the jury is still out on whether iPads enhance learning, hinder it, or have no effect. Yes, it’s true that students can watch video clips on an iPad, and bringing home an iPad is easier on the back than a backpack full of schoolbooks. But I don’t think I’m entirely just a Luddite when I say that I’m doubtful that students can really effectively read, understand, and take notes on textbooks in tablet form as well as a physical book — and, more importantly, so far as I know, schools are implementing iPad programs not subsequent to well-researched studies with control groups, but in a race to see who can be out in front of the others.

And there was a report not long ago of a local school which cancelled its iPad program because they found out that the students were able to hack into it, get past the restrictions, and load it up with games — and because a large number of the iPads simply went missing.

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