January 1st, 2009
Fixing the blame on the EHR mess
I was going to start the New Year with a rant against family physicians getting in the way of health IT reform.
Then I read the actual letter, posted on The Health Care Blog, and learned it’s really a criticism of the health IT industry, not the government.
Current EHR solutions can cost $40,000 per physician and cut productivity 30% during their break-in period, write David Kippe (above) and Brian Klepper.
Instead they suggest simple process changes using the Internet — e-prescribing, incentives for online referrals to specialists, and the use of the Web to communicate with patients.
Meanwhile, improving Internet connections to doctor offices, especially in rural and underserved areas, would reduce the costs of these changes and encourage the transition, they write.
There is nothing wrong with this, but Boston Globe reporter Lisa Wangsness followed up a faulty analysis of the letter with calls to gatekeepers standing in the way of true interoperability, like the CCHIT and HIMSS.
HIMSS is asking for a $25 billion bailout of its industry, mandating EHR purchases by doctors and medical groups. CCHIT certifies such systems without a thought to interoperability.
As a result, Kibbe and Klepper write, putting $25 billion into the industry’s hands now would be a waste.
A step-by-step approach emphasizing interoperability and connectivity, based on the Internet rather than client systems, is obviously the way to go. Kibber and Klepper support that approach.
Doctors, even family doctors, seem ready to move online, recognizing they can lower malpractice premiums if their records are just made more accurate.
The problem is we have big money lobbyists looking for handouts. Separating the special pleaders from the true reformers will be the chief hurdle to health IT reform in 2009.
Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994. See his full profile and disclosure of his industry affiliations.
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