Obama's HIT will likely be a miss

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.