A 50 percent growth in healthcare software investment will halve preventable deaths by 2013, saving more than 20,000 lives in the United States alone.

To those who are used to creating dollar-based IT project business cases, this prediction may be an eye opener. With medicine becoming so expensive and complex, our healthcare analysts seem to be suggesting IT investment is becoming the most cost-effective way of saving additional lives – compared to developing new drugs or surgical procedures, for instance. Is this true?

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There are many new drugs and surgical procedures that can save lives, unfortunately, they are not put into immediate practice. There is a long delay between the time a new drug, procedure or therapy is developed and the time that it is actually in common practice.

A study in the U.S. indicated that from the time new knowledge is ‘discovered’ e.g. in a blinded clinical trial until the time that at least HALF of physicians act on that knowledge is 17 years. Pretty scary. Not only does this reflect the low adoption of clinical automation systems but it also reflects the failure of continuing education for physicians.

But healthcare IT projects can be big and complex - look for example at new patient records administration systems being developed in the UK. Many believe there are high risks with these projects – if not of failure then at least of large cost and time over-runs. Does your prediction imply you believe these problems will be overcome?

For many years now it has been recognized that achieving substantial improvement in the quality and outcomes of the healthcare system requires systemic change. It is somewhat scary to realize that the proper practice of medicine is no longer feasible with unaided human cognition. Over 50% of what a physician learns as s/he goes through medical school is obsolete within less than a decade. This means that there needs to be a paradigm shift on how the practitioner of medicine keeps their knowledge current. Reading a few medical publications and going to a continuing medical education conference a couple of times a year won’t cut it. Gartner is now seeing the emergence of the first ‘generation 3’ computer-based patient record systems. These include a critical mass of capabilities in 6 or 7 key areas – clinical data repository, controlled medical vocabulary, clinical decision support, workflow/business process management, clinical documentation, computerized physician order entry, and knowledge management. The synergy between these components means that automation is now being applied directly at the point of care. Over time, this collection of capabilities will become responsible for ‘informing’ the practice of individual clinicians. It is this development that will be responsible for the next dramatic set of reductions in medical errors and the concomitant decrease in mortality that forms the basis of our prediction.

The timeline on the prediction is so long, not because of failures or complexity, but, because the current penetration of clinical systems is low as is the adoption rate among physicians.

We could hope that healthcare software projects will lead to savings that can be put back into clinical care will that be a key part of this?

There will be savings from Healthcare’s investment in IT, in fact there are many systems have a very short ROI. However, this prediction does not talk to the complex economic factors associated with Healthcare’s investment in IT, it is focus on the savings of lives by the prevention of medical errors that will be enabled by advanced computer systems.

I agree with this point.If we are able to analyse the historical data of particular patient,we can make a prediction, which in turn would help to save lives.This is possile when we have suitable IT system in place.

Adding my 2c worth,

I was amazed to see that there is a 17 year lag before 50% of physicians act on "new knowledge".

I used to work at a healthcare organisation that provided healthcare to extremely low income groups, and most of this was based on a large and complex IT system. The system would take as input all patient symptoms, as well as vital statistics, and then return a list of potential ailments.

The point that I am trying to make is that IT systems CAN and DOES help with diagnosis, as well as proposed treatments (this could be especially beneficial to newly discovered ailments or diseases), as long as people are willing to SHARE information. However there is always the problem of IP ownership, and no one wants to share if they can somehow profit from it.