Health IT in the economic stimulus bill, should we be frightened?

Much has been made of Betsy McCaughey’s analysis of how the economic stimulus package will affect health care.

Although she takes a partisan swipe at the National Coordinator of Health Information Technology, perhaps what’s more frightening is that billions of dollars may potentially be poured into an inadequate health IT infrastructure.

Blogging over at Health Care Renewal, MedInformaticsMD asks whether government can succeed as the primary sponsor of ambitious health IT projects (via retired doc). He points towards the UK which, despite already having a government-run health care system, has spent upwards of $17 billion on electronic medical records that “has not accomplished national health IT but instead [is] a quagmire.”

With a larger system, and one that is significantly more fragmented, the challenge to make electronic records universal in the United States is more complex by several orders of magnitude.

The current generation of health IT companies are responsible for the piecemeal state of electronic medical records. “Hopefully the bulk of funds to conduct this needed research will not go to the ‘usual suspects’ in the IT and management consulting industries,” MedInformaticsMD warns, “the same folks who rewarded the UK with such fine results.”

Comments

Rob
The Health IT coordinator office was instituted by George Bush a number of years ago. It is NOT a “new bureaucracy” as she says. David Brailer was the first one (I think he was appointed in 2004). This was all made in response to Bush’s promise for EMR in all physicians’ offices.
Please make sure this correction is made clear to readers.
Anonymous
It’s just another blaring example of doing the right thing and getting punished for it. Our hospital has paid nearly 1.5 million over the past 5 years to get a fully integrated EMR with surrounding clinics and in the hospital. What will they receive for their foresight and efforts. A handout to the competition. Two competing hospitals will get it done for them free of charge. I guess the lesson is don’t pay your mortgage, don’t make your product better on your own just wait for the government and taxpayers to do it for you.
RoseAG
I’m not so sure that institutions who’ve already bitten the bullet and automated will lose out.
In my experience most IT projects end up being done at least twice before they’re fully functional. The bigger the project the more likely this is to hold true as the political climates tend to distort priorities and cause difficulties in getting something useful implemented.
Since this is by definition a “big” project I think there is a high probability big chunks of it will be useless.
If the law enforces EMR then those who waited for the bailout will be stuck with the first version, which will be not very effective.
Institutions who’ve mobilized to automate will meet the legal requirements more readily and be better positioned for success.
I don’t consider this to be ‘stimulus’ because I don’t see a lot of evidence that IT workers have a high rate of unemployment. I think they’ve just slipped this into the bill because it’s a good opportunity.
Anonymous
Many IT projects that I’ve experienced take several renditions to get things right. The bigger the project the more likely this holds true.
If an institution has already gone to EMR (and 1.5 million isn’t all that much for these things) then they have a chance of meeting the legal requirements in a somewhat efficient way.
Institutions who’ve held off in hopes of a bailout will be left with a “first version” implementation that will probably not be satisfactory.
Generally you get what you pay for.
It would not surprise me if most of the Federal funds get sucked up with analysis activities.
Jax Voice
In considering the Health Information Technology section of the stimulus bill, my biggest concern is that there is far too little consideration for the difficulties in actually attempting to gather and store all of that private information securely.
I am not as worried about the overweaning influence of the government, yet, but I am very concerned that this will be an area of rapidly accelerating difficulties for both integrating medical offices and for the central government institutions responsible for implementing.
I won’t bury this blog with all the data, but feel free to take a look at:
http://suitablesecurity.blogspot.com/2009/02/are-we-looking-at-id-theft-stimulus.html
American Medical Association
To help refute misinformation on the HIT provisions in the stimulus bill, the AMA created a clarification document available to all at http://www.ama-assn.org/go/stimulus-facts. The letter in Wednesday’s Wall Street Journal (below) also specifically addresses what the HIT provisions in the bill will do to help physicians, including providing financial assistance for HIT purchases.
To the Editor:
You admit in your editorial “A Health-Tech Monopoly” (Feb. 11) that electronic medical records “might do some actual good.” We agree, and that is why we support the health information technology provisions of the economic stimulus bill.
The economic stimulus bill being considered will create important national HIT interoperability standards. These standards are essential to achieve the promise HIT holds to help increase patient safety, improve care coordination and reduce unnecessary paperwork. As is true in other industries, basic standards will provide the essential foundation on which the private sector can build innovative commercial products.
Competition and innovation are bedrocks of America’s economic system, as they should be in health care. The HIT provisions in the bill maintain this vision, while building on existing federal efforts to encourage HIT adoption. This bill does not authorize the government to dictate clinical guidelines or national coverage decisions. Medical treatment decisions remain in the hands of physicians.
The bill also provides physicians with significant financial assistance for HIT purchases. This critical support is needed so that physicians can make HIT purchases, and patients can then begin to reap the benefit.
J. James Rohack, M.D.
President-elect, American Medical Association
Anonymous
Some interesting thoughts on how the government could encourage standardized health IT in a much more rational way, and in a much more economically sound way can be found at the following link.
http://drsamonline.com/2009/01/12/miscellaneous/about-electronic-health-records/
Check it out.
Anonymous
There was some clamor the other day about CCHIT, the body that currently “certifies” HIT products. Obviously, open source products aren’t included in the CCHIT agenda. Perhaps an organization such as OpenEMR should also be allowed to “certify” HIT products that might be less costly and more flexible for the clinicians who use them.
EZ_blogger
This is a very interesting discussion that you have started Kevin. I don’t really know which side I fall on this issue. I am very familiar with the medical field and I think alot of cost savings can be achieved with improved implementation of information technology in the health care field but the privacy issues do concern me.
I found a company in Minnesota at the forefront of this issue and they have some good info on the economic stimulus and electronic health records (http://www.lssdata.com/govt/). I believe I heard that they are trying to address many of the possible privacy issues with their software.
I guess time will tell how this is going to play out.

Health IT in the economic stimulus bill, should we be frightened?

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