IT icon­o­clasts speak out

Ex­perts of­fer dis­sent on pol­icy is­sues, tech­nol­ogy im­ple­men­ta­tion

Modern Healthcare - - FRONT PAGE -

Each month, more hos­pi­tals and of­fice-based physi­cians buy and use elec­tronic med­i­cal records and other health in­for­ma­tion tech­nolo­gies as the U.S. presses on to­ward achiev­ing the goal first ar­tic­u­lated by Pres­i­dent Ge­orge W. Bush in 2004: pro­vid­ing most Amer­i­cans with ac­cess to an elec­tronic med­i­cal record within a decade.

Ac­cord­ing to the lat­est data from the CMS, more than 190,000 providers have been paid a to­tal of $10.7 bil­lion to pur­chase and mean­ing­fully use elec­tronic healthrecord sys­tems un­der the fed­eral in­cen­tive pay­ment pro­gram cre­ated by Pres­i­dent Barack Obama’s 2009 stim­u­lus package.

But health IT has long had its crit­ics, even among its pioneers and pro­po­nents, as th­ese four prom­i­nent health IT icon­o­clasts will at­test.

All four con­sider them­selves to be pro­po­nents of health IT, but they rail against a tide of health IT boos­t­er­ism. Their tar­gets: mis­placed pri­or­i­ties, fail­ing to pro­mote EHR us­abil­ity and in­ter­op­er­abil­ity, in­ad­e­quate con­cern for pa­tient safety and pri­vacy, overem­pha­siz­ing EHR adop­tion, un­der­stat­ing IT costs and over­es­ti­mat­ing the re­turn on pub­lic IT in­vest­ments.

When it comes to the crit­i­cism, “the one thing we can’t do with this in­for­ma­tion is to ig­nore it,” says physi­cian in­for­mati­cist Dr. Wil­liam Bria, long­time pres­i­dent of the As­so­ci­a­tion of Med­i­cal Direc­tors of In­for­ma­tion Sys­tems and a three-time se­lec­tion as one of Mod­ern Health­care’s Top 25 Clin­i­cal In­for­mati­cists.

“Ob­vi­ously, the mael­strom of change within health­care, in­clud­ing mean­ing­ful use, re­sults in a weari­ness that could cause physi­cians and other clin­i­cians to be­come ex­hausted and no longer vig­i­lant,” Bria says. “Many, many tech­nolo­gies have come and gone in the his­tory of medicine over the cen­turies, and it of­ten has been a mav­er­ick physi­cian that has called a timeout on in­ef­fec­tive med­i­ca­tions or treat­ments.

“There is lit­tle ques­tion that, go­ing for­ward, medicine will be us­ing in­for­ma­tion tools,” Bria says. “How­ever, I be­lieve it’s be­com­ing also very ap­par­ent that we need a mod­u­la­tion and a proper reg­u­la­tion of in­for­ma­tion tech­nolo­gies used in day-to-day care.”

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