Lessons from Obama: How to waste an IT budget
November 30, 2009 by Valerie HelmbreckPosted in: Budgets and spending, Communication, Data centers, Databases, Green technology, Software, Special Report
Here’s the question of the week: Should the U.S. government shell out the $19 billion that’s earmarked for electronic health records (EHR) if computerization doesn’t improve health care quality, reduce costs or boost administrative efficiency?
Those are the findings of a new study just done at Harvard, and the results are sure to make political hay for plenty of folks in Congress who are looking to block spending on projects established by the American Recovery and Reinvestment Act, which had set aside that $19 billion for EHR.
The new study (which you can read here) evaluated data on 4,000 U.S. hospitals over a four-year period. It found that the enormous price tag for setting up and operating hospital IT systems outpaces any expected cost savings.
It also found that most of the software being written for use in clinics is aimed at administrators, not doctors, nurses and lab workers. That’s not surprising, considering that it’s usually admins — not the folks on the front lines — who make the software purchasing decisions.
One of the study’s lead authors said that the software being peddled to health care institutions is mostly designed for accountants and managers, folks who would use the data output from a computerized system for administration and billing in the institution.
But for the folks who deliver actual health care — doctors, nurses, lab technicians — the software is often something of a bust.
The problem “is mainly that computer systems are built for the accountants and managers and not built to help doctors, nurses and patients,” the report’s lead author, Dr. David Himmelstein, said in an interview with Computerworld.
For years, and across several federal government administrations, there have been predictions of huge cost savings and enormous improvements in the quality of health care through the use of computerized systems. The Harvard study contradicts most of those claims, despite identifying several hospital systems that have had modest success using technology.
While the study appears to be somewhat damning to EHR initiatives, it’s unlikely that it will put the brakes on a growing demand for going digital in doctors’ offices.
Starting in 2011, the Health Information Technology for Economic and Clinical Health (HITECH) Act will be giving out incentive payments of up to $64,000 for each doctor who sets up an electronic health records system and uses it effectively.
Given the findings of the study, it’s that last part that could prove difficult.
FinanceTechNews.com delivers the latest Finance news once a week to the inboxes of over 150,000 Finance professionals.
Click here to sign up and start your FREE subscription to FinanceTechNews!
Tags: American Recovery and Reinvestment Act, doctors, electronic health records, healthcare, hospitals, Software
December 1st, 2009 at 1:38 pm
What a loaded question. Of course we shouldn’t spend 19 billion on software that doesn’t help. That doesn’t mean we shouldn’t spend the 19 billion – the people that are designing the software have to do a much better job.
December 1st, 2009 at 1:50 pm
Hmmmm….$19 billion. Let’s see that works out to over $6000 per every man, woman and child in the good ol USA. Not to mention the $64K win fall for each doctor(multiply that by each doctor in an office) who goes electronic. (..oh some already have…). and at the Taxpayers expense. Seems kinda over kill to me.
Just how much money can we Waste…? I say NO!!!
All the people to do the data entry….( sounds like a business oportunity here…)
Another problem with this idea is even more scary than the money aspect:
Instant access to eveyones medical records and all the sticky details of your physical and mental condition all at the push of a button.
Lets take it to the next level. Software the colates and examines the data on Mr. Smith and to see wheather or not to aprove or disaprove the requested proceedure, all automatically. Ahhhh….But, Mr. Smith really isn’t worth the expendure because he’s not a good contribuitor to the GDP, since he’s not very educated or retired, or just too old…
so out of the automated system pops `Procedure Denied’
You think this won’t happen…give me a break. given where things are going, I would not be supprised at all.
December 1st, 2009 at 1:56 pm
“the people that are designing the software have to do a much better job.”
Come on Gordon, the designers build the software according to the requirements laid out. Unfortunatly, bureaucrats can’t draft up clear requirments.
December 1st, 2009 at 1:58 pm
It has to make you wonder if it’s not about invading your privacy. Keep in mind that there are legal minds who point out that there’s no right to privacy in the constitution. While this is technically correct, none of the first ten amendments are worth the ink to print them if privacy is not assured.
I have worked for organizations that love software that just falls far short of what engineers need, but is loved by the bean counters and executives because it gives them short form reports they consider helpful. Isn’t this the same thing? When the application does not satisfy the needs of the core business itself, it leaves you thinking that the reports to the executive wing are probably not accurately reflecting the business itself.
December 1st, 2009 at 1:58 pm
So why use Obama’s name in the header whne the article itself states, “…across several federal government administrations…?” Why does this “News” organization politicize the news? Also, when they say it doesn’t help, what exactly are they expecting it to help? No enough information here on how the programs are being evaluated.
December 1st, 2009 at 2:12 pm
Mike,
Medical records will all be electronic eventually. Paper records are very inefficient and labor intensive, which is why many industries have already moved away from them. And most paper records are already generated and/or stored on computers and servers, so the security vulnerability is already there. One requirement that needs to be incorporated into any development plan must be security of records.
The $19B may not be justified, or maybe the money can be spent more effectively to improve the end result, but paper records will go the way of carbon paper and mimeograph machines.
December 1st, 2009 at 2:19 pm
While I agree with the majority of what Mike said, his numbers are off since there are currently 308 million people in america (via census.gov) the 19 billion would amount to 61 dollars per american. If the doctors were ever able to tell IT people what they actually WANT from a computer system the software designers could make their lives easier….
December 1st, 2009 at 2:20 pm
Where do I go to get my HITECH (Hi Tech) IT certification????
December 1st, 2009 at 2:28 pm
Mike, you might want to check your math.
Today, the decision to pay for procedures is made by for-profit private insurance company bureaucrats. It’s not “where things are going.” It’s where things are right now. It’s not a good system, there is near universal agreement on that — among doctors, patients, politicians.
EHR systems makes sense … if they can be designed and engineered properly from the use case standpoint. There are many many examples of software products that were initially designed for the managers (takes sales force automation software) that eventually became quite good for the line worker as well.
December 1st, 2009 at 2:28 pm
Wade – obviously you don’t design software. If the designers do their job properly the first thing you do is determine who is the primary user and build it to accomplish their needs. The article states that the software is helping the bean counters and not the doctors.
December 1st, 2009 at 2:43 pm
Gordon –
What sort of company employees you to design software? I think in most, the requirements come via the marketing team and tend to reflect what the marketing team thinks will drive sales. They chat up the people who make purchase decisions. If they can please the people who make purchase decisions, the sales follow.
If you are able to get your requirements directly from hands on users and then design to satisfy thise requirements you are probably an exception.
December 1st, 2009 at 2:47 pm
We definitely need medical people to have good digital computer systems otherwise the microchipping implant program would be highly ineffective. And “Big Brother” would not like that, would he?
December 1st, 2009 at 2:50 pm
Many medical care facilities around the country have already gone to computerized systems. Why spend the taxpayer’s money when hospitals are already doing this on their own? Put the money to a better use…let’s say pay back some of that debt Obama has authorized in the first year of office. And Obama’s name is mentioned because he had to sign the bill to allow the release of the money (of course it could have been under any of the names in congress who voted for a bill that helps put this country closer to declaring bankruptcy, but that does not have the same ring to it)
December 1st, 2009 at 3:41 pm
You have some great points Mr. Beck. However, $19 billion divided by 300 million people in the US is about $60 per person not $6,000 [$19,000,000,000 / 300,000,000] (the arithmetic is easier if you eliminate the 000’s – its the same as $19,000 / 300)
December 1st, 2009 at 3:46 pm
As usual, the product (clinic & hospital software,) is being desgined and written to appeal to the people who make purchase decisions rather trhan those whome the software is supposed to assist.
The answer, of course, is to relocate the purchase decision with the people who will rely upon the system.
I’ve seen hospitals take years to computerize–only to find that the data was then inaccessible and inputing new data unacceptably difficult to enter or retrieve.
My local Hospital/Clinic instituted a special paper form which is valid for printing prescriptions–and then refused to dedicate printers to that form, resulting in a large number of expensive custom forms being wasted. Many of their drs have not learned or refuse to issue prescriptions using the system, resulting in prescriptions being frequently “left out,” of the database.
Part of the problem seems to be failure of system users and designers to recognize that medical records (as opposed to financial, records for the business,) have two very distinct and ver different purposes.
1) They form a continuous, time-line record of a patient’s history, which is very useful for legal purposes, but of limited clinical value. This is the single most common form of medical record keeping.
2) More importantly for day-to-day patient care (a catgory of care which has greatly expanded over the past decades,) a different data organization is more useful.
For instance, anyone on blood-thinners or any of a number of other systemic regulatory medications, is tested regularly in order to monitor care. Such records are most useful when the series of test/dosage records are in a contiguous block so that trend analysis is easier (and such analysis ought to be part of such an inquiry/report!)
For most patients, there are two parallel data sets which are important for current treatments: The history of whatever the current treated condition is, and the history of any chronic complaints and their treatment. As with the rest of this, under the current chronological record order, this information is basically unavailable unless the Dr has done something procedurally to create such secondary rwecords within the patient file. Unfortunately, such secondary procedures often depend entirely upon a nurse remembering to apply the procedure, and when not applied, valuable information is lost from the secondary record, and may be difficult to notice in the chronological record. Missing data points are invisible.
Similarly, the current list of drugs (and other substances, such as herbals and vitamins,) needs to be readily available for each visit, and should be run against whenever a new prescription is added or removed or has a changed dosage to warn of possible interactions (for instance, nephrectomy will lower blood pressure, and if the patient is on a BP regulatory medication, they may easily suddenly become overdosed after removal of kidneys.)
Or two interacting drugs will change the effect of the remaining drug, effectively increasing or reducing the dosage depending upon whether the two positively reinforce or reduce effectiveness.
Both of these instances are relatively easy to program, and insanely complicated to attempt manually.
The current system of expecting patients to know or bring in their medications is time-consuming, error-prone, and could be vastly simplified merely by having pharmacists issue a short form report listing the patient’s medications, prescription numbers, prescribing Drs, dosage and purpose.
While EVERY major pharmacy software package can produce such a compact report, despite much searching and attempts to get pharmacies to provide such reports, I know of only a few which provide the data, and they provide it in a less useful format (usually a dump of prescription labels printed on plain paper.)
Given that such reports, provided to patients by pharmacies and brought to the Drs would save an estimated 5 minutes per Drs visit, and reduce errors by at least 1/3, one would think that it would have been mandated by the insurance companies–but saving money and lives through a low-cost procedure change seems to be an unusually difficult concept to put into effect. At a minimum, the 5 minutes saved per visit, even without the increased accuracy, would be worth billions annually.
Medical data represents an incredibly large and interelated dataset, which has life or death decisions involved. Computers can and should be used to permit those who must use the data with a multitude of analysis tools, checks and balances to ensure that there is as little possibility of error as possible.
Hundreds of thousands of mistakes are made medically every day, luckily, most are not life-threatening, and the majority seem to get caught before causing major damage, but far too many mistakes go unnoticed which could easily be found using data analysis techniques. Given the huge proportion of medical expenses in the US which are related to insurance costs, it makes a great deal of economic sense to attack these issues whenever possible.
December 1st, 2009 at 3:50 pm
Not only should security be included as a requirement, but the methodology necessary to build the medical records products to resist attacks or information disclosure is also a requirement. There are people capable of doing that and resources available to help, but not all software vendors do that.
Standardization for medical record exchange must also be factored in. There has to be a common format for sending my medical records from my doctor’s office to a hospital that ensures accuracy, security and obviously privacy. Any updates to my records at the hospital need to be transferred back to my doctor as well.
EHR is not an impossible goal and over time, if done correctly, it should reduce errors, duplication of tests, and eventually costs. It will not be done overnight.
December 1st, 2009 at 4:49 pm
Tony B, I agree that politicizing any issue just makes the argument more “attractive” rather than than useful. However, the “… across several federal administrations..” part refers to “predictions of huge cost savings and enormous improvements in quality of healthcare…” The key word here is “predictions” not the actual spending of money. On that note, I would guess that Obama’s name was used because A.R.R.A. came under Obama’s watch and that’s where the $19 billion comes from.
Since it’s been “purported” through these studies that the expected gains will not exceed the costs, it would be natural to assume (from an arithmetic perspective) that spending that money would be a waste of an IT budget since it would deliver negative returns… in other words, a waste of your and my tax dollars. Hence the title of this article, which I happen to agree accurately describes the content within it…political or not.
December 1st, 2009 at 5:29 pm
Arithmetic; oops….sorry about that….what I get for talking to some and typing at the same time….
even at $60 a head, its too much, unless doctors / hospitals can use the system , privicy is incorporated with safeguards to prevent misuse by insurance companies and especially our corrupt government.
Personally, even with all the above and good intentions…I think I’d rather take my chances.
December 1st, 2009 at 5:50 pm
If done correctly, that $60 could be a substantial factor in your survival during an emergency room situation. From the administrative standpoint it will be quickly offset by a reduction in billing related expenses by the provider. Electronic medical records is a win-win proposition. Naysayers are more concerned with disrespecting the current administration at any opportunity.
December 1st, 2009 at 6:04 pm
I work in a healthcare facility and deal with both paper & electronic records on a daily basis… I’d like to address several questions & comments at one time.
1) Cost savings: depends on the institution; smaller facilities should see increased savings over time due to the *insane* (and increasing) amounts of paper currently in use, either through habit, medical need or mandate. I’d also like to see the investigators revisit the cost of *time* wasted by physicians, nursing staff, and admin staff plowing through stacks of paper (often covered in illegible scrawls), never mind the purchase cost of equipment.
2) Invasion of Privacy: Don’t worry, your privacy is already purely mythological. Electronic records will benefit us poor sots who have to dig through roomfuls (literally!) of paper to find older information, the nursing staffs who have to deal with “exploding” charts and/or multiple charts per patient, help cut down on transcription mistakes and misreads due to bad handwriting (yes, that does truly happen!), and make inter-facility data transfer easier (ever handle multipl 80+ page faxes in one day?)… Meanwhile, the insurance companies ALREADY have the info and are already basing decisions on it, computerizing the records in individual facilities won’t affect the efficiency of that particular operation at all. There’s also a little thing in the US called “HIPAA” that’s supposed to keep all medical records, regardless of format, private; anyone violating those rules doesn’t need a computer to do so and *will* get caught.
3) Cost per person: In a nation where nobody blinks at $45 to fill a gas tank, $10 for a movie ticket, $8 for a pack of cigarettes, $5 for a single hamburger and similar pricing, why is even a few hundred dollars on a one- or two-time basis to make it easier for medical staffs to provide patient care instead of spend entire shifts doing paperwork such a negative number? You want to “take your chances” and save the money? Don’t come crying to me when you need a bedpan changed and all my nurses have to ignore your call light because none of us can read the physician’s orders coming out of our fax and the EMTs are standing in front of us asking what they’re supposed to do or not do to one of our patients… Make the stuff legible and I’d have a couple of CNAs available to get you your bedpan…!
4) Quality of Software: Aaah, now we’re talkin’. Several times every week (to the point where some of my colleagues are going, “I know, I know…” halfway through my complaint) I end up bitching about how the software is obviously NOT designed by people who have to actually use it on a daily basis. I’ve done systems design, I’ve done interface design, I’ve done user support… and so far almost everything I’ve seen on the market falls far, far short of what I’d consider “good” or even “fair” levels of usability. (NOTE: Even the bad stuff can at least make illegible notes & orders easier to read, which makes life a *lot* easier for caregivers.) Get the designers out of the business offices and into the nursing stations for a few months, THEN turn them loose on the problem…!
Anyway, I think I’ve made my point. EHR may not be the walk-on-water, raise-the-dead, print-money-in-your-spare-time solution that some proponents have tried to make it out to be, but it DOES help the caregivers on many, many levels and SHOULD be installed (with stadardized data formats and high-level security) in all facilities as soon as we’re able.
December 2nd, 2009 at 5:10 am
Would it make lives easier to implement EHR? – probably.
Would it be difficult to create software for doctors and nurses and the bean counters? – sure, but it’s achievable. (theoretically)
The biggest problem is the cost. Believe it or not the only companies who are big enough to outsource this initiative to are the ones big enough to squander your money and then ask for more money to complete an unfinished job. Soon $19B will look like a drop in the ocean.
December 2nd, 2009 at 7:57 am
After reading the article regarding the expensive price tag for computerization of medical records, I would like to comment. In my experience over the years, I would typically agree with Harvard’s outcome…however, my company selected Kaiser (Atlanta, GA) for medical coverage offered to our employees. If anyone is considering records management, he or she may want to look into the system and processes established by Kaiser….they are efficient! Our employees can go to any of the KP facilities and the health record is immediately available….the “user” can go online and print out lab results, required information for a child’s school records or communicate with the doctor with questions that ultimately save on an office visit and co-pay! The doctor does not make paper notes, he or she sits down at the computer during the examination/office visit and keys all appropriate information…one time, clear directions, medical orders such as a mammogram required or prescriptions. The Kaiser system is the most efficient I have ever seen and the doctors and staff love it! By the way, our employees do too!
December 2nd, 2009 at 10:23 am
Richard – I don’t know what makes you an expert on designing software, but what you’re saying is it doesn’t work because software is designed for the purchasers instead of the users. I agree, that’s why its back to the drawing board. Your line of reasoning is EXACTLY why it isn’t effective. Focus on the problem, not the argument.
December 2nd, 2009 at 11:37 am
Gordon
I have been a software developer for 25 years and a lead software designer for the last 15.
I do not really understand what you are trying to say so I will just clarify my view.
1) I think computerized medical records can be very valuable and if spending 19 billion in federal funds can be done to good effect, I have no objection.
2) Getting the right results from a government program depends on structuring the payments around well chosen and well specified goals. Make the program too vague and someone will find a way to use the money for their own needs.
3) If the government program is well structured then the requirements that come down to software designers will match the programs goals. If not, the requirements will match the needs of the people who negotiate the software purchase.
4) Hoping software designers will do the right thing and focus on the needs of doctors and nurses even if the contract terms focus on the needs of administrators is unrealistic. Putting the blame on them when the software serves administrators better than doctors is unfair. Management will say “First, meet the terms of the contract”
December 2nd, 2009 at 12:14 pm
Richard – Again, we’re both saying the software isn’t designed properly. You’re pointing out who is to blame, I’m saying generically, the “designers” aren’t doing their jobs. I’m not talking about the person writing the code – I’m talking about the people that are supposed to find out what the software has to do. You don’t have to be designing software for 25 years to know that – it’s “Software 101″. I’m saying don’t spend 19 billion for software that isn’t designed properly, but I’m not agreeing with the implications of this article – which seems to be bashing Obama for wasting 19 billion on poorly designed software.
December 2nd, 2009 at 1:23 pm
Gordon
I think Finance|Tech News is showing an anti Obama bias that is gratuitous and it seems you agree.
The people “that are supposed to find out what the software has to do” are the ones who negotiate the contracts. If they are conscientious they will bring both end users and software designers into this effort but if they have not done that, the software designers are not going to be able to do much.
If by saying the “designers” are not doing their job you mean the administrators are failing to insist on the right requirements in the contracts then we agree.
I cannot imagine a contract for software written to say “Have your software designers talk to our users and figure out what we need. We will buy whatever they decide on.”
This is my last post on this topic
December 2nd, 2009 at 1:44 pm
The headline is pure Faux News. Unsubscribing.
But, first, I applaud Brian Lev’s comments. I work for an insuror (Blues) and they’re not all as nasty as people try to make out; lot of dedicated people. And gettting rid of paper is essential to efficiencies and outcomes.
KMC
December 2nd, 2009 at 2:30 pm
Well Richard, I THINK if I were going to spend 19 billion on software that was USE-FUL, I would spend some time talking to USE-ERS.
Brian Lev gets it: “Quality of Software: Aaah, now we’re talkin’. Several times every week (to the point where some of my colleagues are going, “I know, I know…” halfway through my complaint) I end up bitching about how the software is obviously NOT designed by people who have to actually use it on a daily basis. I’ve done systems design, I’ve done interface design, I’ve done user support… and so far almost everything I’ve seen on the market falls far, far short of what I’d consider “good” or even “fair” levels of usability. (NOTE: Even the bad stuff can at least make illegible notes & orders easier to read, which makes life a *lot* easier for caregivers.) Get the designers out of the business offices and into the nursing stations for a few months, THEN turn them loose on the problem…!” – Thanks Brian
Richard – I really would never hire someone with this “I didn’t do it” attitude. Administrators shouldn’t be designing software. In very simple terms – users should be talking to designers and designers should be listening.
December 2nd, 2009 at 3:12 pm
Like Avery, I too have experienced very efficient and effective use of EHR (not at Kaiser, but locally at a very well run clinic). I feel that the underlying issue is it’s the cost and PROPER implementation as alluded to very clearly in Richard’s previous post. In Richard’s 3rd point “.. if the government program is well structured..” I find a compelling argument that to me, justifies this article’s “political bias” if you will.
When was the last time you’ve every heard of a federal government program ending up costing less than what it was originally slated to cost? I’m sure there might be an isolated example or two but compare that to the original projected cost of Medicare vs its actual cost, not to mention a Social Security system slated to go broke in a few years, and you already have two shining examples of government’s inefficiency at running anything. True, these problems didn’t start with Obama’s administration, but they certainly won’t end with it either. We’ve already seen how the so-called “stimulus legislation” (A.R.R.A.) has not exactly lived up to it’s expectations (10.2% unemployment vs a projected “ceiling” of 8%). So how can we expect such a government to efficiently spend $19 billion of our taxpayer dollars and come up with something that won’t cost us 10 times that amount in 10 years, much less something that runs efficiently and is not riddled with fraud and waste? We’re already suffering from this economic downturn, why aggravate it by adding more taxes to fund poorly run government programs. As I mentioned in a previous post, I don’t like politicizing anything and I apologize in advance, but instead of seeing “Hope and Change” from our government lately, all I’ve seen is “Hope this works…” I really do hope it does work because we are clearly on an unsustainable path and need to closely watch what and how our government spends OUR money.
For those of you who say “…well, what’s YOUR solution”? How about doing something that has been proven to work? Fix the economy first; get rid of the “too big to fail” mentality, shrink the size of government and get the private sector moving again through government incentives, NOT bailouts. Let the private sector come up with the innovation and expertise to develop and implement cost effective and useful EHR systems (we already have them and private enterprise will make them better). But that’s another complex issue that requires it’s own thread (I’m not trying to start one) and given the direction our leadership has taken, that’s not likely to happen anytime soon anyway. While I truly “Hope this works” I’m very skeptical.
December 2nd, 2009 at 3:20 pm
Gordon – I said I was leaving this conversation but I guess I need to say why.
Your condescension does not produce a useful exchange.
You have impugned my credentials and when I provided them you reversed course by suggesting that “software 101″ would be sufficient credentials.
You have insulted me personally without addressing the content of my statements.
You pretend you have a simple answer but do not offer it.
I see nothing in what Brian Lev says that I disagree with. The software is bad – Granted. Better communication between software designers and end users is vital – Granted.
Tell us how to make this communication happen without resorting to a simplistic accusation that it is “software designers” who “need to do a better job”.
Lastly, I have no interest in being hired by you (assuming you actually hire people).
December 2nd, 2009 at 5:00 pm
Richard
If you are offended by my remarks then I apologize. I’m stating what needs to happen and you seem to agree yet you always add but it’s not the designer’s fault. You want to take the design responsibility away from the designer and give it to some administrator or bureaucrat and that’s it. I’m saying if it isn’t working for the people that use it, find out why. The reason I used the “Software 101″ analogy is because you can save a lot of time and work if you do that first. A bureaucrat or administrator may not know that but a software designer should.
And yes I do hire people – with solutions, and on occasion I even design and program software. But you should know that the first to sling arrows was you: “What sort of company employees you to design software? I think in most, the requirements come via the marketing team and tend to reflect what the marketing team thinks will drive sales. They chat up the people who make purchase decisions. If they can please the people who make purchase decisions, the sales follow.”
Well, obviously that system didn’t work. So should we say “It can’t be done because the system doesn’t work that way?” Or should we go back and see what can make it better? I say the latter – you seem stuck on the former.
To review – The article makes the point that we are wasting 19 billion on software that isn’t effective because “most of the software being written for use in clinics is aimed at administrators, not doctors, nurses and lab workers”. I said it needs to be designed to work for the users. You and others say I don’t know what I’m talking about because it’s not the designers fault and it seems that marketing teams and purchasers do the designing.
I can’t believe that a designer maintains the position that designers don’t design software.
Well, maybe we are wasting 19 billion. But at least it’s not the designer’s fault.
December 2nd, 2009 at 5:22 pm
Gordon – your very first post said:
“the people that are designing the software have to do a much better job.”
Wade suggested there was more to it
Your second post said:
“Wade – obviously you don’t design software.”
Perhaps my question about what kind of company you design software for was a bit snide but it sure did not start there.
December 3rd, 2009 at 10:32 am
As frequently happens with these articles, the comments have been dominated by a struggle between a few “experts” who seem to have gotten off track. From reading the article, it looks to me like the study primarily looked at IT systems and software that was designed and then sold to hospitals, clinics, etc. And since the administrators are the ones who normally make the final purchasing decisions, the software was written to appeal to them. (Gotta love capitalism – it’s the profit that’s important; not the value of the service or product delivered… but that’s another story related to letting private industry solve the problem, as many suggest.) I don’t see anywhere in the article that software designers did not do the job they were given; just that, generally speaking, the job they were given apparently did not do much to directly benifit doctors and nurses.
I think most of us agree that money spent on modernizing the healthcare industry’s record keeping processes can be money well spent, as has been demonstrated by some systems already in place. The challenge is to make sure that government funds intended to help that transition along are spent on the right types of projects, which means that the requirements must be targeted to achieve the desired outcome, clearly spelled out, and then strictly adhered to.
December 3rd, 2009 at 11:12 am
Bravo dritchie
You have just written the sort of comment I should have. I took what I saw as scapegoating of software designers a bit too personally and addressed my response to Gordon.
It would have been much better if is had simply mentioned I support well managed investment of $19B and offered my own view on the complex nature of the problems in making the investment effective.
For whatever it is worth, my wife is an end user of EHR software at a mid size hospital and her reaction was that the software she deals with is pretty darn good and does focus on the needs of he people who deal with patients.
December 3rd, 2009 at 11:15 am
Bravo dritchie
You have just written the sort of comment I should have. I took what I saw as scapegoating of software designers a bit too personally and addressed my response to Gordon. That was a mistake.
It would have been much better if is had simply mentioned I support well managed investment of $19B and offered my own view on the complex nature of the problems in making the investment effective.
For whatever it is worth, my wife is an end user of EHR software at a mid size hospital and her reaction was that the software she deals with is pretty darn good and does focus on the needs of he people who deal with patients.
January 14th, 2010 at 2:12 am
This is some valuable information, I just finished my paper for class and think I should go re-edit it lol. You may have just made me a regular