I have been observing the federal initiatives regarding increased funding of healthcare information technology (HIT) with a bit of a jaundiced eye. I have blogged in the past about the high failure rate for the deployment of hospital EMRs. Here is one example of such a note: EMR Failures and a Recipe for Their Avoidance in the Future. Many of the leading EMR products are expensive, outdated, and could possibly result in less efficient operations for hospitals installing them rather than productivity gains. A recent article in the New York Times provides what I think is an accurate assessment of the negative consequences that could result with an influx of federal money into HIT (see: Doctors Raise Doubts on Digital Health Data), Below is an excerpt from it with boldface emphasis mine. Read the whole article for other important insights.
Now that the federal government plans to spend $19 billion to spur the use of computerized patient records, the challenge of adopting the technology widely and wisely is becoming increasingly apparent. Two articles, to be published [shortly] in the New England Journal of Medicine, point to the formidable obstacles to achieving the policy goal of not only installing electronic health records, but also using them to improve care and curb costs....In the [second] article, identified as a “perspective,” Dr. Kenneth D. Mandl and Dr. Isaac S. Kohane portray the current health record suppliers as offering pre-Internet era software — costly and wedded to proprietary technology standards that make it difficult for customers to switch vendors and for outside programmers to make upgrades and improvements. Instead of stimulating use of such software, they say, the government should be a rule-setting referee to encourage the development of an open software platform on which innovators could write electronic health record applications....In the Mandl-Kohane model, a software developer with a new idea for health record features like drug allergy alerts or care guidelines could write an application, and those could be added or substituted for a similar feature. Such an approach, they say, would open the door to competition, flexibility and lower costs — and thus, better health care in the long run.
The lobbying pressure to channel money to the leading EMR vendors and stimulate an avalanche of new EMR installs in hospitals will be formidable. For example, the leading HIT membership society and professional accreditation group, HIMSS, actually described itself as a "trade association" in a press release (see: HIMSS Describes Itself as a "Trade Association" in a Press Release). This unfortunate, but accurate, description of the organization was quickly expunged from its web site. HIMSS execs will certainly be staking a claim on the newly available federal money on behalf of their favorite EMR companies. Hopefully, the hospital CEOs and CIOs will be able to withstand these efforts to purchase and install proprietary "pre-Internet era software" and hold out for the next generation of what hopefully will be superior products.
:: Update on 3/27/09 @ 9:18 a.m.
John Moore of Chilmark Research has additional comments on the topic above (see: Siloed, Tethered PHRs are a Dead-end).
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