Show me the (bailout) money!

Jan. 3, 2012
The Obama bailout plan includes $20 billion for HIT. YES! Finally – an administration that not only gets it, but is willing to put its money where its mouth is. (Where is an administration’s mouth anyway? Never mind, I digress.) $20 billion!
The Obama bailout plan includes $20 billion for HIT. YES! Finally – an administration that not only gets it, but is willing to put its money where its mouth is. (Where is an administration’s mouth anyway? Never mind, I digress.) $20 billion! Our problems are solved! Where’s line for the cash? What? $18 billion of it will be spent at the State level ($2 billion is for the Office of the National Coordinator)? Well, sure, the States have a stake in all this – and hey, they have such a great track record handing out money. $18 billion. My institution is a ‘meaningful user’ of HIT, but how many state lobbyists will I have to stand behind (or hire) to get my money? Come to think of it – what will I do with the money? Sure, I have lots of things to buy: a new data center, more staff, newer CABs (COWs, WOWs, BMWs – whatever you want to call those darned heavy carts). Of course that’s not what the money is intended for – PHR, EMR – that sounds more like it – RHIO? Why not? $18 billion…

The truth is, it’s not hard to spend that kind of money and still see little societal value. John Glasser, CIO for Partners Healthcare warned in a recent Wall Street Journal article (Waste Feared in Digitizing Patient Records – WSJ 1/22/09), that we should not rush to spend the money. He is right – we must spend it wisely, not quickly. Are grants for demonstration projects at the State level a good spend? I don’t know, perhaps, but a better goal is spending the money to take the industry towards real, strong, mandated standards. The kind that will force my ED and OR systems to be able to transfer data to my inpatient system without requiring a supporting cast of thousands. The kind of standards that will let me tell a physician – ‘sure, we can send that data to your office EMR’. The kind of standards that will benefit patients without requiring a massive layer of costly middleware.

I’m really glad the Obama administration has the vision to understand that HIT is vital to improving the state of healthcare. I hope they have the strength to see past special interests to mandate standards and enforce compliance. Perhaps, grants can be set up to help vendors migrate to the standard. Yes, some vendors won’t survive the migration. That’s okay – we could use a thinning of the herd. Let’s help the providers who are left hanging move to vendors that will be compliant. Sounds simplistic, and it probably is – but does it have to be so much more complicated? It would be a real shame to see billions spent without meaningful value.

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