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This morning, FORTUNE and Kaiser Health News released a report on our multi-month investigation of electronic medical records, which you can read here. The story, written by two of the industry's best health journalists – Erika Fry of FORTUNE and Fred Schulte of KHN – has nearly 10,000 words and, once you get started, you will surely want to read each of them. In fact, this is one of the most fascinating, surprising and deeply troubling stories about our health system that I have read for a very long time. It's also one of the features I'm most proud of having published FORTUNE's editor-in-chief.
While, at first glance, the subject – your computerized medical records – may seem like a brilliant white paper, it's a story that touches you directly, to you and your loved ones. This is the evolution of your medical data when you visit a doctor or hospital – and the invisible technology (and too often glitchy) that can affect the care you receive, without you ever being wiser.
This same technology – the EHR – also represents the biggest change in practice for physicians since the advent of the HMO and is decisively contributing to another, often hidden, medical crisis: the burnout epidemic doctors.
According to a study conducted in 2017, physicians spend an average of 5.9 hours per day of work on electronic medical records. Annals of Family Medicine. That's more than they spend with patients. (As crazy as it may seem, these data are backed up by other research, including that of 2016 published in the Annals of Internal Medicine. You can also ask any doctor of your choice to give you an estimate of their expenses for these systems and the amount of time lost.)
Earlier this year, Medscape released a survey of 15,000 physicians about their personal experiences of burnout and depression. It offered a breathtaking badessment of the level of frustration, hopelessness, and other emotional trauma experienced by many of the same professionals who are responsible for taking care of us.
The suicide rate among physicians is more than twice that of the general American population. And the Medcape survey suggests that even apart from those who end up committing suicide (about a US doctor a day), a lot of them are in crisis: in the US. survey, 44% said they were "exhausted", while 15% said they were either "familiarly depressed" or "clinically depressed".
Burnout, due to physicians' own admissions, too often ends up affecting patient care. Thirty-five percent of these 15,000 respondents admitted to being "easily exasperated by patients"; 26% reported being "less motivated to take notes with patients (for example, history, completing the EHR."); 14% categorically said, "I make mistakes that I might not normally do."
Break on this data point for a moment.
Although there is not a single cause for this epidemic of burnout, about one-third (32%) cited a well-known culprit: "Increasing computerization of practice (DSE)".
How did we get there? How did we come to a place where so many doctors are handcuffed to a technology they absolutely hate, attached to unintuitive systems that many describe as endless labyrinths and numb menus that take them a way practical care for patients?
This is the essence of the remarkable story of Erika and Fred, "Death By Mille Clics", which I invite you to read. It's a story of unintended consequences of a scale that is hard to imagine – a $ 36 billion federal investment that has pushed physicians and hospitals to scan medical records without defining a framework or rules ensuring that all this data can be easily shared. (Imagine a financial system where everyone has an ATM card, but the cards only work in one bank.)
But it's not just bad planning or government waste. It's more about hurting people, as Erika and Fred show. Although such incidents, injuries, and near-accidents related to EHRs are often not reported – or worse, are protected from the public – the numbers we have make knowing about will shock you completely.
It's amazing, as you'll see, the reports. And I'm delighted that Erika and Fred are immersing themselves in their story in person at FORTUNE Brainstorm Health on April 2nd and 3rd.
Erika and Fred will join the leaders of Microsoft Healthcare, One Medical, the Biden Cancer Initiative and other experts for a conversation led by Lloyd Minor, Dean of the Stanford University School of Medicine – which we are delighted to say that he is an academic partner for our conference.
This is one of the essential and timely conversations we are looking forward to having at Brainstorm Health. We're going to dig into where A.I is making the biggest difference in medicine (and where it's not) with Dr. Eric Topol, author of a deeply insightful new book, Deep medicine.
We'll talk about the power and risks of big data with Mayo Clinic Leaders, IBM Watson, Tempus, Verily, Palantir, Intel, Color, Livongo, Project Ronin, and the US Department of Health and Data Data Manager. . Human Services, among others. We will explore the next business models with Bruce Broussard, CEO of Humana, Paul Jacobs, CEO of XCOM, and Toby Cosgrove, inimitable Google, and explore the rapid evolution of R & D with Hal Barron of GSK.
We will be joined by 40 industry-leading health CEOs (and industry transformers), more than 20 corporate founders and visionary non-profit organizations, change agents from eight medical institutions 10 of the brightest investors and venture capitalists we know more about. And like every year, we will have many wonderful surprises.
You can check the range here. Hope to see you there!
Sy will be back with more tomorrow.
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