Health IT: Can We Fix It? Yes We Can!

Every presidential candidate, Republican and Democrat, talked about Health IT as part of the solution to our health care woes for two years’ worth of campaigning.  Electronic Medical Records (a subset of Health IT) specifically have been pushed by outgoing HHS Secretary Mike Leavitt and incoming HHS Secretary Tom Daschle, who points out that we have a 21st century health care system but a 19th century record keeping system.  All along, we were told that medical transactions would be more efficient, errors would be prevented, and we would save money.  We were pointed to the successful use of electronic medical records in the VA Hospital system and, as with any shiny new program, visions of maximum efficiency danced in our heads.

On Dec. 6, as part of his YouTube/Radio address, Obama listed the priorities for his economic recovery plan, including “[something] that won’t just save jobs, it will save lives. We will make sure that every doctor’s office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year.”  This was it.  After hearing about it for so long, it was real.  It was happening.

After two years of wine and roses, the backlash was inevitable.

Here’s Maggie Mahar on Health Beat talking about how current Health IT systems are not ready for prime time, and certainly not ready for an influx of cash.

Here’s Mike Leavitt in the Washington Post warning that this would be wasteful spending unless specific concerns about interoperability were addressed.

Here’s Robert Laszewski on Health Care Policy and Market Place Review citing substantial savings from Health IT as one of his five myths of health reform.

And there are many more I can cite.  To be fair, the savings value of Health IT was certainly overplayed during the campaign—the Congressional Budge Office estimates it would save only $2.2 billion a year over the next ten years if required providers to be compliant with health information technology as a condition of Medicare .  The concerns with the various Health IT products currently on the market are not new.  All are works in progress.  For example, e-prescribing products tend to be pretty good, but Electronic Health Records (EHR) are all over the map.  Some EHR systems need more input from doctors to function smoothly, some need stronger software or security.  All of them need more “interoperability” – the ability to interface with other systems so we truly have a national network. There’s an awful lot of “we can’t yet” in the air now that a serious investment in technology development and in helping doctors with the costly process of getting set-up and trained on the systems is imminent.

The question is not do we have the killer app – the Microsoft Word-esque, industry-standard type of program that we can invest in with no reservations.  The question is do we have something “good enough” to withstand an influx of users and also be fixed and improved along the way. Clearly Bob the Builder would disagree, but he’s hardly an expert.  But for all the skeptics, there are plenty of experts filled with hope – like John Halakama on the Health Care Blog, who says:

“Let's implement EHRs now and realize their benefits. Let's implement the interoperability for administrative transactions, labs/rads, and e-Prescribing that is robust today. Then let's implement the clinical summary exchange that's coming soon. It's a journey and we should start immediately. There is no reason to wait. “

We may only have “good enough” and not great.  We may see a small savings rather than large ones.  But there’s no question that the more providers we have using the systems offering feedback, the quicker the programs will become better (Web browsers wasn’t all that and a bag of chips when they first came out, either).  The more people we have using today’s systems, the less “start from scratch” training we’ll need to do 5 or 10 years down the road.  Most importantly, the more political will we put behind the Health IT effort, the more immediately we can improve the efficiency and quality of health care as practiced in this country.  And isn’t that the real point?

(Photo credit:  mewm172 on Flickr.)