Five Reasons Why Health IT Is Sick
With the stroke of a stimulus package pen, the United States doubled the size of the health information technology market. In an industry mired in paper and unable to meaningfully share a patient’s vital health information between care providers, it should be a "no-brainer." Except the problem (easily spotted by anyone who has worked in the IT industry long enough to see enterprise system implementation failures) is that adding computers to an inefficient process just makes the process more expensive, not better.
If we want to see real progress in health care, we must move beyond the political arena and figure out how researchers, care providers, payers, and patients can make better health-related decisions with technology. There are five areas where the past year’s health reform debate is largely missing the mark.
1. Define “better.” A workable definition of better might be “delivering therapies that will work safely for that patient.” The HITECH act uses "meaningful use" to describe a successful organization's adoption of electronic health records for purposes of qualification for federal funding. More generally, "better" seems synonymous with cheaper, faster, more electronic, more visible, and/or more efficient. Though those dimensions are important, "better" should at least include the perspective of a patient's health. We should be more intelligent in our use of advanced analytics to target and predict positive patient outcomes.
2. Decision-oriented data collection The value of information is only in what you can do with that information. The current focus on electronic health records and related infrastructure risks side-stepping the real work in figuring out what to do with all that information. And if you don’t know what you are going to do with data, you won’t collect it properly. We have started to see some acknowledgment of this problem, but much more work is needed. Currently, clinical decision support will be considered in phase 3 of many organizations' adoption of electronic health records — far too late to properly inform implementation plans.
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