Following Health IT

I have been starting to follow the debate about improving health care by improving health care IT. Health and Human Services and the US CTO, Aneesh Chopra had an open web conference followed up with a blog with open comments. I posted a comment there about the disconnect between how Electronic Medical Records(EMR) systems are precieved by providers and by everybody else with some suggestions.

This debate really resonates with me. One the one hand, there is this belief that improving EMR systems will lead to efficiencies. As is so often the case with IT initiatives though, the case seems based on faith more than on facts. As the debate has developed it is becoming more obvious to me that much of this discussion is just shifting the effort of making sense of free text doctors notes from those who want useful facts to those who provide the facts. In otherwords, rather than a doctor writing on a piece of paper that can be scanned and presented graphically, they need to fill out a form with stuctured fields on it that are needed by all the downstream consumers of the information. The doctor, or perhaps a records tech in the practice, needs to codify the notes to make data available at their cost, rather than a records tech at the consumer’s location. Either way somebody has to do this. Since this could be a fairly specialized task, should it really be distributed across tens of thousands of small doctors offices, clinics and hospitals? I wonder.

This isn’t the only problem I see and I’ll post more as time goes on. But, what really is resonating with me is how often we spend time rushing to solutions with paradigms we already know when understanding the problem is only partially done. Sure, sometimes these can happen together, but in the case of health IT, thinking really needs to precede action.

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