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Taking the Public's Pulse on Health IT

September 4, 2009
by David Raths
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For obvious reasons those of us who think and write about health information technology for a living spend most of our time talking to CIOs and other experts immersed in the field. But it also can be valuable to talk to friends, family members and neighbors about their perceptions of the push for a national health information network to see how the idea is permeating the culture in general.

A vacation or long weekend like Labor Day can provide a great way to get away from the phone, e-mail and online meetings and engage in these conversations. Another way is to move and have your cable company screw up the installation schedule of the wiring for your new home office. That's what happened to me this past week.

Being suddenly unplugged for four days made me angry at first, but after a while I found the peace and quiet kind of enjoyable. (I especially didn't miss the cable TV and almost want to tell them not to bother setting it up when they finally do show up.)

I used the down time to chat with new neighbors as well as some friends and tennis buddies. It's always interesting to gauge their reaction when I tell them I write about health IT issues for a living.

One of the first things I notice is that many people aren't aware that the stimulus bill contained so much money and has generated so much activity. President Obama has referred to health IT in several speeches, but I would guess most people couldn't describe many details about what is happening.

But many people are eager to give their opinions about healthcare reform in general. Although the majority here in Philadelphia voted for Obama and support insurance reforms, they voice skepticism about the claims that health IT investments are going to lead to greater efficiencies and help bring costs down. "Make the argument that this is worth investing in," one friend said, "but don't tell me it's going to eliminate waste or fraud. They have never done that before."

Perhaps having experienced a few failed software projects in their own work, they have doubts about one so large being successful. When I describe what regional, state and federal health information exchange groups are trying to accomplish, their jaws drop and they give the impression that they don't really believe it's possible.

Most people I speak with also don't know whether their own physician's office has started using EHRs or not. And although they would like access to their personal health information online, they have come to expect less from health providers than from banks, airlines and Netflix.

When I told her I wrote for Healthcare Informatics, my own physician, who is in an independent, two-person practice, gave the impression that she hoped to avoid going electronic as long as possible. You might think I should look for another doctor, yet I think she is the best primary care doc I have ever had. And I can understand her reluctance to invest the time and money on the difficult changeover in her small office.

My circle of acquaintances is small and not meant to describe a sampling of public opinion. I don't know if polling has been done on the public's ideas about health information exchange. But I think it's important for all of us to step back every once in a while and try to understand the perceptions of people who don't work in the field every day — and to engage our own physicians about their experiences.

What kind of reactions have you had from family and friends when describing the flurry of activity in your field?

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Comments

Mark,
People keep telling me that converting those primary care physicians in the one- and two-person offices will be one of the biggest challenges in this whole endeavor, and perhaps our anecdotal experience with our own doctors helps explain why.

David,
Excellent post! And your report of your primary care physician's response mirrors precisely my own of a few months ago. My PCP is young-ish (50), meaning he's not some old curmudgeonyet he is positively retrogressive in his attitudes towards healthcare IT investment and innovation. He's even a bit sarcastic about my writing for Healthcare Informatics! Yet, like you, I'm going to stick with my PCP, because of his strengths as a clinician and a good medical adviser. Still, as I wrote in a blog a few months ago, it does shock me that he is so skeptical, even cynical, about healthcare ITand he's in a two-office practice that could absolutely use an EMR!

I will say that most non-healthcare peoplei.e., people I know or have met personally who are not inside the industryagree immediately with the idea that it's ridiculous that healthcare is so backward in terms of IT, compared to other industries. As I constantly say, who would fly on an airline that required you to check in at your departure gate by filling out paper-based forms in triplicate? And who would bank with a bank that offered no ATMs? It's fascinating to interact with people socially and let them know I write about the kinds of topics I write about for Healthcare InformaticsI find it always triggers fascinating conversations!

David Raths

Contributing Editor

David Raths

@DavidRaths

www.linkedin.com/in/davidraths

David Raths’ blog focuses on health IT policy issues ranging from patient privacy to health...