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Obama's HIT will likely be a miss

Examiner Editorial
-
March 1, 2009

There is a provision of the $878 billion stimulus package rushed through Congress for  $20 billion to develop a centralized national health information technology (HIT) system. Proponents claim HIT will save $77 billion over the next 15 years and greatly reduce medical errors. Who could possibly object to that?

Well, for starters, ask medical care providers in Britain’s National Health Service (NHS), who have been trying to get their HIT system to work properly for the past five years. The cost of NHS’ HIT has escalated to six times the original estimate – the U.S. equivalent of $18.4 billion - to serve just 30,000 physicians in 300 state-run hospitals, a fraction of the medical care providers in the United States. In January, Public Accounts Chairman Edward Leigh reported to fellow members of Parliament: “Essential systems are late or, when deployed, do not meet expectations of clinical staff.” HIT is such a mess that Leigh recommended funding “alternative systems” if things don’t improve within the next six months. But even if HIT is eventually junked, British taxpayers will still have to pay for it.

The National Academies of Science noted that much of the electronic medical data collected in the U.S. is “used mainly to comply with regulations or to defend against lawsuits, rather than to improve [patient] care.” A large 2003-04 study of 1.8 billion ambulatory patients discovered that the use of electronic health records provided no difference in 14 of 17 quality care indicators, produced significantly better care in just two, and worse care in one. And a summary of 33 studies done in Europe between 1985 and 2009 found that HIT actually causes a significant number of medical errors.

After spending billions of dollars during the past three decades, only four percent of U.S. physicians have a fully functional HIT system, says Drexel University’s biomedical informatics professor Scot Silverstein – and it’s not because doctors don’t want to use technology. These expensive systems are just not designed for their extremely complex and highly specialized needs. In an open letter to President Barack Obama, Silverstein says that “HIT is an experiment...unproven on a large scale.” Computers in hospitals have also been linked to the spread of MRSA, a deadly antibiotic-resistant staph infection. Yet the same federal government that can’t keep its own military veterans’ medical records secure is bound and determined to spend $20 billion in a top-down, centralized effort that has a very good chance of messing up yours.



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Reader Comments

All comments on this page are subject to our Terms of Use and do not necessarily reflect the views of the Examiner or its staff. Comment box is limited to 250 words.

GWS

Mar 2, 2009

The Examiner - The official newspaper of the Republican Nation Party. You bias is astounding.

 

S. Silverstein

Mar 2, 2009

Health IT is nonpartisan. See the National Research Council report here: http://tinyurl.com/avdnc9

 

antonio m

Mar 2, 2009

Give President Obama time to settle

 

Anon

Mar 2, 2009

antonio m: "Give President Obama time to settle" George Bush started the National Program for Health IT in 2004.

 

M

Mar 2, 2009

the national medical records project was started in 2004 by George Bush.

 

Ed Porcaro

Mar 2, 2009

You mention a study but do not provide a citation so that we can read it for ourselves. Please provide a link to the research. Thanks

 

btenney

Mar 2, 2009

Obama has been a failure in all his previour endeavours, why does any think this will change. I predict he will resign by the end of his first hundred days.

 

J Orient

Mar 2, 2009

If a system makes things easier, cheaper, and/or better, you don't have to force people to adopt it. The politicians who wax enthusiastic about HIT apparently know little about medicine or what is useful or counterproductive in the medical record. And apparently they have never coped with a power outage or system crash.

 

D Kross

Mar 2, 2009

"The cognitive disruption of clinicians caused by user unfriendly devices such as these generates potent avoidance strategies that far exceed the impact of cost. The doctors are not Luddites. They are, in fact, clever, to have not fallen for the scam."

 

anesthesiologist in Illinois

Mar 2, 2009

HIT legislation is about government control of our medical care. This is not about improving medical care. This is about gaining control of physicians and denying and rationing medical care. It will provide lots of money to a few individuals who will design this system which will never work.

 

therapygirl

Mar 2, 2009

maybe bush should come back and see how his HIT system has caused many deaths and let the families know it wasn't because the the medical issues they were in the hospital for; it was from a system that has made many errors!! Let's see how he will justify that. UPMC has covered up all of these deaths?? Whose to answer for them??

 

mistersafety

Mar 3, 2009

Certain components of HIT are medical devices. It is not clear how FDA regulation was sidestepped. The HIT systems would be better apt to provide meaningful function had they gone through the rigors of the pre-market approval process. There is a strong case for FDA regulation.

 

mynameisjob

Mar 4, 2009

I don't agree with this article. We need more investment in health IT to improve quality of care in this country. EMRs that are connected to each other, will improve the quality of care. There is network effect here - the more doctors have EMR, the more useful the information will be. If we only have 15% with doctors using EMR right now, it is difficult to improve quality because there is still lots of info on paper. It is like having only 15% of people with email access. We still would need to use snail mail to communicate most of the time and studies would have shown that "email" is not a very efficient mode of communication. Now that most everyone is using email the efficiencies we see are gigantic.

 

Doctor Doctor Mr. MD

Mar 5, 2009

mynameisjob writes: "I don't agree with this article. We need more investment in health IT to improve quality of care in this country. In medicine, we like to use a scientific approach towards assertions of clinical benefit. Which scientific journals are you quoting from? Or is your faith in healthcare computers a religion of some type?

 

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