WALL STREET JOURNAL LETTER

This posting copies 2 recent letter to the Wall Street Journal concerning the Health care portion of the stimulus bill. I cannot agree more with the sentiment of these authors. Having some experience in Health care IT, I find it to be an instacne of wishful thinking that throwing billions of dollars into health It will help to make patient safety better, or eliminate waste. The problem is that the Health IT folks try to make it all inclusive, promising everything and delivering a clunky system that does not function well. This was quite evident when UCLA went all digital to great fanfare several years ago, but had to quit after there were so many problems with the system.

"The collateral damages from the HIT stimulus will be far worse than you project. Since free-market competition has not yet winnowed the 300-plus electronic medical records (EMR) systems to a viable number of good products, the stimulus will favor the old, clunky, entrenched products over the newer and fleeter.
In the meantime, a 2005 study on EMRs and health-care fraud done for the Department of Health and Human Services showed that EMRs will make fraud initially worse. The HIT billions will be spent to speed the uptake of bad systems and help to increase health-care fraud.
This is like dusting off the infamous Yugo automobile and spending billions so that everyone has his own bad car by 2014. And, more sadly, it's probably a done and irreversible deal. It would be merely another pathetic exposure of government gone wild if so many patients, doctors, and health-care institutions weren't doomed to suffer for this, leaving aside the demise of better, more conscientiously designed electronic medical records systems. But, at least everyone will have an EMR. I guess that is what matters in America today, keeping an ill-informed, short-sighted, nonrational, dogma-driven promise."
Reed D. Gelzer, MD, MPH, CHCC Data Quality and EHR Integrity Consulting Advocates for Documentation Integrity and Compliance Wallingford, CT and Boston, MA


"You observe that the true political goal is socialized medicine facilitated by health care information technology. You note that the public is being deceived, as the rules behind this takeover were stealthily inserted in the stimulus bill.
I have a different view on who is deceiving whom. In fact, it is the government that has been deceived by the HIT industry and its pundits. Stated directly, the administration is deluded about the true difficulty of making large-scale health IT work. The beneficiaries will largely be the IT industry and IT management consultants.
For £12.7 billion the U.K., which already has socialized medicine, still does not have a working national HIT system, but instead has a major IT quagmire, some of it caused by U.S. HIT vendors.
HIT (with a few exceptions) is largely a disaster. I'm far more concerned about a mega-expensive IT misadventure than an IT-empowered takeover of medicine.
The stimulus bill, to its credit, recognizes the need for research on improving HIT. However this is a tool to facilitate clinical care, not a cybernetic miracle to revolutionize medicine. The government has bought the IT magic bullet exuberance hook, line and sinker.
I can only hope patients get something worthwhile for the $20 billion."

Scot Silverstein, M.D. Faculty Biomedical Informatics Drexel University Institute for Healthcare Informatics PhiladelphiaPrinted in The Wall Street Journal, page A16

Amen to these smart physicians and their warnings about Health IT.