Why health care costs so much

At least part of the reason that health care costs so much is due to arcane software and poor information systems design. I had to have a routine blood test this morning, and went to the hospital to do it so I could take care of it early in the day.

The whole process kicked off at a desk in the lobby where I had to fill out a slip of paper that was carried by hand to the patient registration folks. After a twenty-five minute wait, I finally got to talk to a registration person. This is where everything went seriously off the rails. I've been to the hospital before for this sort of thing, and they had a record of me in the computer. But the poor woman registering me clicked away with her mouse and typed for six full minutes. I thought I was on line at at airline registration desk--the only other place where I see long periods of typing going on for simple tasks.

The registration process generated at least 18 sheets of paper that I could see, and I suspect several more were generated at printers whirring in the background. Part of the time was spent checking data like date of birth, addresss, and phone number, which they already had but had to ask again, in a tedious process repeated daily in tens of thousands of doctor's office and medical facilities around the country. And of course, there was the requisite photocopying of my insurance card. I suspect that every day, we probably use a forest's worth of trees making copies of insurance cards.

The actual process of taking a blood sample, including being greeted by the nurse, rolling up the sleeve, printing labels for the samples, and putting on a band-aid, was under three minutes.

Total elapsed time: 40 minutes.

What should and could happen? This business of photocopying the insurance card is insane. The hospital has computers. The insurance company has computers. We have this thing called the Internet. Insurance companies and health care providers could establish an open standard to verify insurance coverage electronically, with much higher reliablity than a worn piece of pasteboard carried around in a wallet.

Today, you can buy a thumb drive with 2 gig of memory on it for under fifty bucks. This would hold my entire medical history, from birth, including a good sample of important X-rays. It could also hold some personal information like address, phone number, and next of kin. Instead of endlessly and repeatedly manually filling out forms and entering data, we could carry one of these, with something like thumbprint biometric secure access. Instead of many minutes of typing, I would plug it into a little keypad at the registration desk, enter a PIN number and a thumbprint, and everything needed to would transferred (and only what was needed, under the patient's control). Quick, easy, and more accurate than hand data entry.

This is not a difficult technical problem. I suspect it has more to do with the health care establishment's fear of giving more control to patients. But ultimately, we pay, one way or another. We should be in control, not underpaid and overworked clerks (who are really controlled by IT staff who have failed miserably to be of any real service to their clients and customers).

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