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Is HITECH a buzz-kill?

November 18, 2009
by kate
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I’ve noticed a strange pattern lately. The majority of conversations I’ve had with CIOs, consultants and other industry experts in the past few months have veered toward the subject of HITECH — and not because I led it that direction.

It can be a discussion on anything from patient identification to wireless implementations, and somehow it keeps going to back to the ARRA-HITECH Act that is taking the healthcare IT industry by storm. CIOs are itching to talk about it — and not because they want to sing its praises, but because they are very, very concerned about what lies ahead.

The most common themes I’ve heard are as follows:

· Deadlines are too tight; everything seems rushed, and when it comes to IT implementations that change the way care is practiced, that’s never good

· Meaningful use still isn’t defined, and there’s no end in sight

· Small, community hospitals don’t have the resources required upfront to roll out CPOE (the organizations that don’t need funding will be lined up to collect dollars)

And then there’s this one:

· HITECH just doesn’t seem very well thought-out

Ouch. This is what CIOs and other experts are saying about the biggest thing to happen to the industry since the Internet. Frankly, that scares me, and it’s made me think that perhaps the Act that’s supposed to accelerate the adoption of electronic records just may end up hindering it.

And that maybe if government tries to force the hospital executives’ hand by rushing a process that shouldn’t be rushed, it could end up killing the buzz that EMRs have created over the last several years. Don’t get me wrong, I certainly agree with the overall goal of digitized medical records, and I understand that requirements are needed to make sure tax dollars are appropriately spent. Believe me, I get that. But what I don’t understand is, what’s the hurry? If ever there was a process that shouldn’t be rushed, it’s the deployment of systems that will drastically impact clinician workflow, patient care, and much more.

I’m just not so sure we’re going about this the right way, and apparently, a lot of CIOs don’t think so either.

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Comments

Hi David, thanks for the comment. I understand what you're saying if there are no deadlines/incentives, there's a good chance no progress would be made. I just worry that this just isn't the kind of thing that can be rushed. If only there was a happy medium, right?

Hi Kate,
I hear many of the same things from CIOs, but it must be tough to please everyone if you are in David Blumenthal's shoes. If the HITECH Act did not have aggressive deadlines attached, another set of people would be bemoaning the fact that this effort runs the risk of losing steam and stalling. Or they might say that without the immediate carrot/stick of incentives/fines, healthcare entities will find a way to put off making the investments necessary. I'm not saying that's what I think, but there's definitely a faction that would yell "Too Slow!" to match the one that is curently yelling, "Too Fast!"

Kate,

Thanks for driving this discussion.

I was at AMIA last week. There, with two thousand others, I attended David Blumenthal's plenary presentation.  Packed room, of course. No new details as far as I could tell. But, he mentioned almost in passing, that CMS doesn't know what the rate of adoption will be of HITECH incentives.

I thought to myself for the first time, "Of course they don't." How could they. To your point, we don't know how high the hurdle or how far away it is for each of us. And it is different for each hospital and eligible provider.  And, to the point you clearly raised, our industry tends to move at 25 MPH, not 80 MPH. Wow. What a wild card for CMS!

Although I agree with David Raths' observation that there is a three bears problem (too hard, too soft, and just right) with the hurdle height, I think Michael Mandel, chief economist for BusinessWeek has described the real political driver. Sequencing. The dems need to improve the coverage definition situation.

A later step will then be possible to address the costs. In my post, Non-Goals, I propose that EHR adoption and it's funding should follow that reality. That lets us get to a close enough and low enough hurdle, in a context that will address the agreed upon True Goals.  (There's a link to Mandel's observation in that post.)

kate

Kate Huvane, Associate Editor of...