Why does it take healthcare so long to adopt new technology?

Back in the ’90s, when ’N Sync and Backstreet Boys were competing for the No. 1 spot in tween girls’ hearts, and everyone was wearing low-rise, boot-cut jeans, Paul Chang, now a radiologist at the University of Chicago, was developing a piece of technology that would fundamentally change medical imaging forever.

That technology—a type of image distribution mechanism called dynamic transfer syntax—was used to create PACS, or picture archiving and communication system, which digitized medical images so radiology techs no longer had to lug around boxes of pictures from CT scans and X-rays. Chang described it as the Google Photos of medical imaging.

Though PACS was a huge technological advancement back in the ’90s, it hasn’t really changed at all since then. In fact, Chang said PACS is “primitive,” as are electronic medical records (EMRs).

“It’s amazing how primitive our systems are. And I think that’s a risk to healthcare. Certainly it’s a risk to inefficiency, waste, and cost of healthcare, but I also think it’s a quality issue as well,” Chang said.

What takes healthcare so long to adopt new technology?

The healthcare industry tends to slowly adopt new technologies because lives could be at stake and security is so important, prompting extra caution, Chang said. You don’t want to leave important medical decisions up to artificial intelligence (AI) unless you’re 1,000% sure it’s going to be right, right?

“That’s an excuse we give everyone to be lazy,” Chang said.

The real reason? There just hasn’t been a financial incentive, thanks in part to the fee-for-service reimbursement model.

In the fee-for-service model, healthcare workers are paid just for providing a service, say, administering an X-ray, without taking into consideration the quality of the care provided and how the patient fares. Because hospitals don’t have to compete against each other to provide better service, there’s no incentive to invest in technology to improve efficiency, he said.

“Because of fee-for-service, we didn’t have to compete. Fee-for-service is kind of a fixed game in our favor. That’s starting to change with shared-risk models and capitation,” he said. Generally speaking, we, in healthcare, did not have to compete against each other.”

That’s starting to change with the nationwide push toward value-based care, so the incentive to invest in IT and advanced technology is there now, but healthcare is still far behind other industries. “Fifteen years behind,” Chang quipped.

“This is part of the problem of why healthcare is so expensive and so inefficient, and I think potentially dangerous,” Chang said.

How could that be dangerous? Healthcare providers could use advanced technologies like AI to see patterns in someone’s health history and determine which diseases they’re at greatest risk of inheriting and screen for those, according to Chang.

“The EMR should tell us that. The EMR should look exhaustively throughout the world and say, ‘This patient with a particular genetic profile, what is the absolute best treatment we can provide?’” Chang said.

“The threat of your smartphone is it knows too much about you, yes? Well in healthcare, we don’t know enough about our patients,” he added.