NYT author is using a Government mandated program to question the benefits of technology
The New York Times author is using a Government mandated
program to question the benefits of technology.
IMO the economy has beaen profoundly affected by technology
and will be more so in the future.
Ken
Why the Economic Payoff From Technology Is So Elusive
By STEVE LOHR JUNE 5, 2016
Your smartphone allows you to get almost instantaneous
answers to the most obscure questions. It also allows you to waste hours
scrolling through Facebook or looking for the latest deals on Amazon.
More powerful computing systems can predict the weather
better than any meteorologist or beat human champions in complex board games
like chess.
But for several years, economists have asked why all that
technical wizardry seems to be having so little impact on the economy. The
issue surfaced again recently, when the government reported disappointingly
slow growth and continuing stagnation in productivity. The rate of productivity
growth from 2011 to 2015 was the slowest since the five-year period ending in
1982.
One place to look at this disconnect is in the doctor’s
office. Dr. Peter Sutherland, a family physician in Tennessee, made the shift
to computerized patient records from paper in the last few years. 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.
“I’m working harder and getting a little less,” he said.
The productivity puzzle has given rise to a number of
explanations in recent years — and divided economists into technology
pessimists and optimists.
The most prominent pessimist is Robert J. Gordon, an
economist at Northwestern University. His latest entry in the debate is his new
book, “The Rise and Fall of American Growth.” Mr. Gordon 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.
The optimists are led by 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. That has been true for a
range of technologies, including the electric motor and the internet, which
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. Just wait.
Some economists insist the problem is largely a
measurement gap, because many digital goods and services are not accurately
captured in official statistics. But a recent study by two economists from the
Federal Reserve and one from the International Monetary Fund casts doubt on
that theory.
Technology spending has been robust, rising 54 percent
over a decade to $727 billion last year, according to the research firm IDC.
Despite all the smartphone sales to consumers, most of the spending is by
companies investing in technology to increase growth and productivity.
But an industry-by-industry analysis, published by the
McKinsey Global Institute, the research arm of the consulting firm McKinsey
& Company, found that the march of digital technology across the economy
has a long way to go. The McKinsey researchers examined 22 industries, measuring
not only investment but also the use of technology to change how work is done.
Some industries, like technology, media and financial services, were well
along, while others, like health care and hospitality, trailed.
Only 18 percent of the American economy is living up to
its “digital potential,” the report concluded. And if lagging industries do not
catch up, we will not see much of a change in national economic statistics,
said James Manyika, a director of the McKinsey Global Institute.
Since the financial crisis, the Obama administration has
moved aggressively to push 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.
The billions of dollars in subsidies were intended to
accelerate adoption. And 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, according to the
most recent surveys by the American Hospital Association and the government.
“The government funding has made a huge difference,” said
Dr. Ashish Jha, a professor at the Harvard School of Public Health. “But we’re
seeing little evidence so far that all this technology has had much effect on
quality and costs.”
The electronic records, health experts say, represent
only a first step toward curbing costs and improving care. “People confuse
information automation with creating the kind of work environment where
productivity and creativity can flourish,” said Dr. David J. Brailer, who was
the national health technology coordinator in the George W. Bush
administration. “And so little has gone into changing work so far.”
The government incentives came with timetables for
adopting different levels of use and new reporting requirements, with the
prospect of financial penalties for doctors and hospitals that fell behind. The
early goals for adopting electronic records were reasonable, health experts
say, but the later stages were too aggressive.
Overwhelmed doctors protested, and the administration
recently shelved the previous timetable, stretching out schedules and modifying
some reporting rules.
Healthstar Physicians, the 50-doctor group in Morristown,
Tenn., where Dr. Sutherland practices, was spurred to go electronic by those
federal incentive payments, which now total $32 billion. But the cultural
adjustment to digital technology has been challenging.
Dr. Sutherland and his colleagues evaluated several
technology providers and chose Athena Health, which does not sell software but
is paid a percentage of its customers’ revenue. Healthstar started using
Athena’s cloud software in 2012, first for billing and then for electronic
health records. Athena’s share is less than 5 percent of the group’s revenue.
Today, Dr. Sutherland’s personal income and the medical
group’s revenue are about 8 percent below where they were four years ago. But
in 2015, both his earnings and the revenue of Healthstar, which employs 350
people in 10 clinics, increased slightly, by nearly 3 percent from 2014.
Dr. Sutherland decided he did not want a computer screen
separating him from his patients. So he opted for a tablet computer, making it
easier to keep eye contact.
Not a fast typist, Dr. Sutherland decided to use voice
recognition software. For six months, he stayed up until midnight most nights,
training the software until its speech recognition engine could transcribe his
comments into text with few mistakes.
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.
Yet Dr. Sutherland is no hater. 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 values being able to tap the screen to look up
potentially harmful drug interactions and to teach patients during visits. He
can, for example, quickly create charts to show diabetes patients how they are
progressing with treatment plans, managing blood glucose levels and weight
loss.
He is working harder, Dr. Sutherland says, but he
believes he is a better doctor. Blunt measures of productivity, he added,
aren’t everything. “My patients are better served,” he said. “And I’m happier.”
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