Death and EMRs: Disruptive events?

The deaths of the past week have set me to thinking. The mother of a friend passed away early in the week followed by the wife of a family friend. Then, news of the death of cultural icon, Michael Jackson, was everywhere.

I come from a family and culture (New Orleans-based) where death is an intrinsic part of life. It very much affects those who are touched most directly by the loss, but it is also integrated into day-to-day life in such a fashion that life moves on with barely a ripple. The deceased is celebrated and mourned in one or multiple events ranging from wake to jazz funeral. Burial in above-ground graves and mausoleums (the water table in New Orleans is very high) caps off the events, and the cemeteries are daily reminders of the short-term nature of life. As with everything else in New Orleans, after death there is a party, but there is real disruption only for those immediately touched by the death. Life goes on.

I married into a family that shares the more traditional views of death held by most of American culture. It is not to be talked about too openly, lest it be invited to approach. And, as for most people in our culture, death is definitely considered to be a disruptive event, dislocating those related to the deceased from the ordinary course of life for an extended period of time. In fact, the disruption is frequently so severe that it is no surprise to those around the survivors that they are forever changed.

The term disruptive technology was introduced by Clayton M. Christensen in 1995 and together with his modification disruptive innovation has become a catch-phrase for technological change that is so radical that it dramatically alters the course of events that follow. If you read any articles about technology, you will come across the terms.

On the way to an event yesterday, we were listening to a podcast of The Week in Technology (TWIT) in which Twitter was discussed as a disruptive technology…disruptive to the field of journalism and to our whole way of communicating and thinking about news events. The techno-nerds who are the mainstay of TWIT are convinced that the immediacy of communication enabled by Twitter is and will continue to radically alter the way in which we receive information, likely becoming the jumping off point for even newer innovations in the realm of communication and information sharing.

I find myself wondering if Electronic Medical Records (EMRs) will not become the same kind of disruptive technology for our current healthcare system. Since EMRs have been around  for a while now, many would argue that they will certainly change healthcare, but do not reach the level of disruptive technology. But when I think about many of our customers in the behavioral health community and the radical changes to their organizations that will be required to move to EMRs and to use them in a meaningful way, I can imagine few more disruptive events.

Some would say that managed care had the potential to be just as disruptive…it certainly changed the way in which private mental health practices have conducted themselves over the last twenty years…but it did not intrinsically change the way in which the provider interacts with the recipient of healthcare services. The consumer may be seen less frequently and for a shorter total length of treatment, the managed care organization may refuse to pay for certain types of care (which the patient can then purchase with their own dollars), but the provider still sees the patient, assesses the problem at hand and provides treatment.

EMRs have the potential for changing that sequence of events. If used in a “meaningful” way, if decision support tools and treatment protocols that are based on scientifically assessed methods (evidence-based treatment) are incorporated into the EMR products and utilized by providers at the point of care in the way envisioned by the framers of HITECH, we will have a new healthcare system….or maybe not.

What do you think? Will widespread adoption of EMR systems be a disruptive innovation for healthcare? Do behavioral health EMRs have the potential to be disruptive technology for the mental health community?

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