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Demand to spend government $'s on HIT hits MSM

The NYT editorial yesterday chastising physicians and the U.S. health system for not adopting electronic medical records adds a new MSM voice to the debate regarding technology as the no-brainer foundation of health reform.    Naturally this is a frequent topic in the trade mags/blogs in my inbox.   The chief implication in the MSM editorial however is that "public financing" is the key factor that would accelerate EMR adoption in this country, as it seemingly has in other countries.    Not surprisingly, there is also an active number of bills in Congress looking to increase the government spend on health information technology -- with varying formulas and priorities.

There is no doubt that if the government provides a lot of financing for EMR adoption by physicians that there will be more computers in doctor's offices and hospitals.   The real question however is will the right technology investments be made that generate the most value - for the physician, for the citizen/patient and for health outcomes.    Unfortunately, the health IT landscape is littered with large, often government sponsored projects, that consume resources but fail to deliver the expected outcomes for a variety of reasons -- poor design, lack of adoption by users, too slow, automate the wrong things and so on.    Just spending more money on information technology -- without looking at all the factors driving behavior in our health ecosystem (payment reform in terms of what we pay for and who pays it and consumer expectations) is unlikely to achieve the expected outcomes.

Clearly, I believe information technology is a critical component of improving health outcomes...or I wouldn't be investing time and resources in building solutions.   Further, I believe that payers need to work with providers to finance investments in improving health outcomes -- of which information technology is a key factor.  At an early stage, some good work is going on with good early results, such as in Massachusetts.   Given that the Federal government is involved as a payer in a significant portion of health spend (nearly 40% by some accounts) - it needs to participate in the solution or other payers won't.

So what is my main point?  We (our government) has scarce resources...they should use them wisely and carefully.    I want to make sure that investments in information technology have a high return to users, payers, citizens and health outcomes.   There is lots of electronic data out there today -- medication histories, lab results, diagnostic images -- and just making these available to physicians and patients alike at the point of decision making -- may generate desired outcomes (lower cost and better care) at a much lower technology spend level.    Yes, paper charts are archaic and sub-optimal and will ultimately be replaced by digital systems.    We can achieve our shared goals of better "value" from our health system (better outcomes for the spend) -- faster and cheaper -- by unlocking the digital data that already exists (Esther Dyson made this call for data liquidity several years ago) and incentivizing physicians and consumers to use the data.    Let's not be satisfied with waiting for EMR adoption to happen.