Doctors have built a legendary reputation around their unintelligible penmanship. Considering their long working hours and the vast amount of paperwork they must fill in, they could be excused for failing to writing legibly – until you look at the worst that could happen.
A 2016 study on the allocation of physician time revealed that instead of looking after patients, doctors spend two-thirds of their time doing paperwork. Many doctors know that regardless of their efforts to produce accurate medical records, the information they generate will likely end in a filing cabinet. At first blush, then, it would make no sense to devote time and energy into the production of neatly handwritten documents. The devil, however, is in the details.
According to the Institute of Medicine (IOM), medication errors resulted in 7,000 deaths and 1.5 million dispatchments of wrong prescriptions in a one-year period in 2006 in the US alone. Albert Wu, member of the IOM and a Johns Hopkins professor, defines a medication error as a failure in the chain of events between the prescription of a medicine and its effective use ranging from prescription, ordering, dispensing, administration and monitoring.
Medical jargon is hard enough to interpret by unknowledgeable individuals. To the untrained eye, a sloppy handwritten prescription for Metadate, an ADHD medication, is not very different from methadone, a heroin substitute. If you believe this example is too far-fetched, you might want to read about this 4-year-old girl whose parents were accidentally dispatched methadone alongside eczema cream, these children who became ill after accidentally being administered an overdose of methadone by a hospital as they underwent surgery, or this girl who was supplied with methadone instead of antibiotics by her pharmacist. From a financial point of view, medication errors can cost institutions up to US$3 billion annually. The IOM aims to solve this issue by going digital.
In the US, leading technology companies including Dell, Google, Intel and Microsoft, have launched a project called eRX, a web-based tool with the objective of implementing a free system to enable electronic prescriptions. E-prescriptions are meant to provide pharmacies with accurate and error-free information. Aside from this goal, eRX intends to create a database with the capacity to gather individual patient information and to check for harmful drug interactions, ensure correct dosages are prescribed according to specific needs, and so on.
As Big Data has begun to play a critical role in diagnosis and research, the digitalization of databases and implementation of electronic processes holds the potential to boost efficiency in life-saving efforts. Despite all the benefits resulting from technological advancements, however, weak financial investment on devices and technological training can result in a broken healthcare system with patients paying for the consequences.
Mexico holds down the bottom places in OECD’s healthcare rankings. It occupies the last position in availability of magnetic resonance equipment as it has on average 2.1 devices for every million people when the average should be 13.3. Besides healthcare technological scarcity, medical schools do not place a heavy focus on the development of technological skills. Aging doctors who have gathered the most expertise in their specialty may not want to adapt their processes to a new system and even if they did, the number of public clinics with internet access is unknown.
In 2017, IMSS spent MX$139,000 from its MXN$59.8 billion budget on computers for its administrative areas. In other words, the investment in the most basic computing units required to run electronic processes constitutes 0.00023 percent of IMSS’ expenses. Even so, the adequate purchase of hardware does not suffice to reach the needed technological conditions to implement digital healthcare tools. Institutions also need to invest in talent to provide service, integrity and security to the system.
Investment in medical technological infrastructure should be holistic. Even if a clinic acquires the most advanced technological equipment, a security breach in the server could replicate the cyberattack a hospital in Los Angeles suffered after all its medical records were taken hostage by ransomware, leaving medical personnel no choice but to communicate in person and fax and forcing doctors to scribble on paper.