WASHINGTON, D.C. — Chatting with health IT leaders from such developing countries as Tanzania, Nigeria and Lesotho — and with the people in the U.S. public sector doing their best to assist them with limited resources — here at the mHealth Summit, a few things are becoming obvious:
- First off, it might seem that U.S. health care providers face an uphill struggle with their electronic health record (EHR) implementations, but it’s nothing compared to what it’s like in developing countries. It’s been said to us Americans a thousand times before, but before you start whining about how hard this transition is stateside, take a look in the mirror for a moment and take stock of the situation: We take our riches — which in this case include a bounteous IT infrastructure already in place — for granted. This conference brings into stark relief the contrast between the West and a good share of the rest of the world.
- Second, on the question of tablets versus laptops: There’s nothing like rough service to determine which device stands the test of a health care environment. So far, the winner appears to be ruggedized netbooks that cost less than $500, in some cases less than $300. They’re heavy, but encased in rubber; and like the latest and greatest tablets, they have touch-screens.
- Third, about software features and interfaces: It turns out that when a doctor or nurse doesn’t have a choice in the first place, they’re fine with having an EHR system to run, period. In Africa, public-domain EHR systems are being run on netbooks with Windows and Ubuntu. And they work. The open-source Ubuntu operating system is gathering steam among users. Why? Because it has many fewer malware issues to deal with — if any at all.
- Fourth, when it comes to incentives, this is great: A Department of Defense project leader said that the netbooks they have deployed among African health workers — who basically are running remote telehealth practices for physicians who can’t be in many villages at one time and need to manage tens of thousands of patients from a central location — are incentive enough all by themselves. Why? One perk the health workers get from their netbook is its camera, and that makes it much appreciated.
“They had nothing before,” an attendee from Nigeria put it to me out in the hall. “And now? They have a camera.”
Does your $44,000 suddenly seem like a cornucopia overflowing with cash?
This isn’t to say that all U.S. health care providers have to do is wave their magic wands and the health infrastructure will build itself. Or that it will be simple. Or that our system of commercially developed software is somehow inferior to open-source. That would be naive beyond believable.
But there are several camps in the U.S. health IT world: Leaders getting it done despite sometimes daunting shortages in enthusiasm and funding; worker bees doing the best they can to keep up with those leaders; and a rear guard being dragged into it kicking and screaming.
If that latter clan could be dropped into Africa for a couple months and see how those countries are accomplishing more with nearly free resources, they’d probably change their tune pretty quickly, roll up their sleeves and get to work. Compared to many of the international visitors here walking the halls at this mHealth conference, U.S. docs have it easy — and have absolutely nothing to complain about.