Saturday, January 31, 2009

Healthcare IT Stimulus and EHRs

The 20 billion dollar Health IT stimulus could potentially force doctors to choose "between VHS or Betamax at a time when we see Blue Ray on the horizon".
I fear that any large scale government spending on health care IT, especially in the area of EHRs (Electronic Health Records), will end up being corporate welfare for the large, established IT vendors. There are a lot of smart people developing the next generation of health care computing, but unfortunately they may be shutout from the market if this spending plan comes to fruition.

I've seen over the past several years how federal and state dollars have been wasted in creating RHIOs. Many of these RHIOs found that after the initial grant money dried up, there really wasn't a compelling business value that would lead to sustainability. The grant funds just made these entities chase some misguided business plan/vision which really did not address true needs in the community for which providers would be willing to pay for.

If EHRs are truly vital to the efficient and safe delivery of health care, and actually help physicians and other providers do their job well, then these end users should pay for the technology themselves. The argument made from the other side is that the cost of EHRs is more than physicians can afford. I think then, the real issue is, perhaps the current crop of EHRs is based on old, clunky, expensive technology. Unfortunately, we may not get to see the future technology for EHRs if the government dumps billions into forcing physicians to buy current systems.


Steve said...

You are so..right on..I am a physcian that has been involved in the HIE movement for over a decade and am sick of the Technology sector preaching and selling us the "Koolaid" that EMR's are going to solve all of that is broken in health care.

In reality the EMR is not the correct starting point anyway to delivery the momentum of a paradigm shift from "ink to electrons".

What is needed is a web based, ASP modeled, eHealth Utility that deals not only with clinical information but also financial considerations.

The eHealth Utility needs to theoretically create a "small cloud of electrons" that surrounds the patient as they move into and through the Health Care Ecosystem. It doesn't have to be "interoperable" intially and needs to start as a very simple platform. With adoption there will be viral growth with demonstration of increased productivity and positive ROI. This will be the stimulus that will spark the evolution of a complex interoperable Health Information Exchange.

AS you alluded to the main reason it has not happen yet is because of greed, power, control and money

Robert A. Ficcaglia said...

Funny you should mention a "cloud" solution --- this type of simple "cloud" platform exists now, and seems to be focused on ROI of the small practice vs. grandiose visions. See: