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June 8, 2016

Technology hasn’t changed healthcare – yet!

Your smartphone allows you to get almost instantaneous answers to the most obscure questions. More powerful computing systems can predict the weather better than any meteorologist or beat human champions in complex board games like chess. But all this technology seems to have little impact on economic development. For example, the rate of productivity growth from 2011 to 2015 was the slowest since the five-year period ending in 1982.

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One place to look at this disconnect is in the doctor’s office, writes the New York Times. Dr. Peter Sutherland, a family physician in Tennessee, made the shift to computerized patient records from paper. There are benefits to using electronic health records, Dr. Sutherland says, but grappling with the software and new reporting requirements has slowed him down. He sees fewer patients, and his income has slipped.

The productivity puzzle has divided economists into technology pessimists and optimists. The most prominent pessimist is economist Robert J. Gordon. He contends that the current crop of digital innovations does not yield the big economic gains of breakthrough inventions of the past, like electricity, cars, planes and antibiotics. On the other hand we have optimists like Erik Brynjolfsson and Andrew McAfee, co-directors of the M.I.T. Initiative on the Digital Economy. They argue that there have always been lags between when technology arrives and when people and institutions learn to use it effectively. The internet for example, only contributed to the last stretch of healthy productivity growth in the late 1990s and early 2000s. The gains from current tech trends like big-data analysis, artificial intelligence and robotics, they say, will come.

Technology spending has been robust, rising 54 percent over a decade to $727 billion last year, according to the research firm IDC. But an industry-by-industry analysis, published by the McKinsey Global Institute, found that the march of digital technology across the economy has a long way to go. industries, like technology, media and financial services, were well along in the use of technology that was invested in, while others, like health care and hospitality, trailed.

Since the financial crisis, the Obama administration aggressively invested to drag medicine into the digital age. As part of the economic recovery package, Congress enacted the Health Information Technology for Economic and Clinical Health Act of 2009. The legislation provided for federal incentive payments of $44,000 a physician to shift to electronic health records. From 2008 to 2014, the share of hospitals with electronic health records rose to 75 percent from 9 percent, while the adoption rate in doctors’ offices rose to 51 percent from 17 percent.

Still, there seems to be little evidence so far that all this technology has had much effect on quality and costs. However, the electronic records represent only a first step toward curbing costs and improving care, according to healthcare experts. Information automation is not the same as creating the kind of work environment where productivity and creativity can flourish. And little has gone into changing work so far.

But there is light at the end of the tunnel.  Dr. Sutherland bemoans the countless data fields he must fill in to comply with government-mandated reporting rules, and he concedes that some of his colleagues hate using digital records. But despite the extra work the new technology has created and even though it has not yet had the expected financial payoff, he thinks it has helped him provide better information to patients. He is working harder, Dr. Sutherland says, but he also believes he is a better doctor. His patients are better served and he is happier.

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