'Digital Doctor' Robert Wachter changes his tune, sees real progress in digital health

LAS VEGAS – Robert Wachter, MD, is not nearly as grumpy as he used to be about EHRs. At least that's what he told the standing-room-only crowd at the CHIME CIO Forum at HIMSS18 on Monday.

Wachter is chair of the Department of Medicine at the University of California, San Francisco. He is also the author of "The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine's Computer Age.”

"If you had heard this talk two or three years ago, he told his audience, it would have been pretty grumpy,” he said. “I find today things are getting a lot better.”

He pointed out that 10 years ago fewer than one in 10 American hospitals had electronic health records. But today, fewer than one in 10 do not.

"It's not hyperbolic to say that in the last decade we've gone from the most information-intensive industry known to man whose information backbone was a piece of paper, a post-it note and a fax machine to one whose information backbone is the electronic health record and all the digital tools that surround it.”

Wachter also gave credit to the government for helping with the transition.

“For $30 billion, the federal government succeeded in digitizing a $3.5 trillion industry," he said, referring to the HITECH Act, which helped fund the digitization of health records.

But the thing that heartens Wachter the most these days is that we're starting to see examples of this idea of reimagining the work. "The technology is very important," he said. "But to me, this is where the critical issues are, he said. To me, the key issue is how will this really works for real patients, real doctors, real organizations."

As for emerging trends, Wachter is watching the transition to value-based care closely.

"Our new mandate is value. … You and I are now under pressure that we were not under 10 years ago, to deliver care that is high-value, better, safer, less expensive, more accessible, more equitable."