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February 25, 2009
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President Obama: Don't Spend Money on Epic

Posted on: 1.3.2009 10:37:13 AM Posted by Suresh Gunasekaran

I received the following news update through many colleagues and RSS feeds that I use….

(Begin story)

The Boston Globe (1/1/09, Wangsness) reported, “As Barack Obama prepares to spend billions on health information technology as part of his plan to revive the US economy, some specialists are warning against investing too heavily in existing electronic record-keeping systems.” In fact, David Kibbe, a “top technology adviser to the American Academy of Family Physicians,” and Bruce Klepper, a healthcare market analyst, highlight “the challenges confronting Obama's proposal to digitize an enormous and fragmented healthcare system” in “a recent open letter to the President-elect.” Klepper argued that “current systems are expensive, cumbersome to use, and cannot easily exchange information about patients' health histories and treatments among different hospitals, labs, and doctors' offices.” And, although “Obama and many health policy analysts support a large investment in electronic health records,” Klepper and Kibbe advocated for spending “the bulk of” the package on “simpler and cheaper technology.” (End story)

(Begin rant)

Klepper and Kibbe do a great job of stating the obvious: current systems are expensive, cumbersome to use and cannot easily exchange information. Exactly; if they were perfect and cheap, everyone would have them and the President would not need to buy us all an EMR.

The real question at the heart of this open letter is far more interesting than their contrived recommendation. If President Obama does invest a great deal in healthcare information technology and much of the money is directed at the EMR space, will it spur investment from new players or will this be the chance for some of the monoliths of the industry that have gotten us this far to accelerate their move to more nimble solutions?

(To read the posting in its entirety, visit

Healthcare Informatics 2009 March;26(3):12-14

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