Stop the HIT Glitches and Delays for Better Care

Water is essential for life, but floods are destructive. Health information is essential for life, but floods of information, software, hardware, techs, consultants, and salespeople are too much -  too much for cost, too much for patients to comprehend, too much for physicians with established practices, too antiquated for new physicians/best business practice/best care.

This week is another announcement of another CMS delay/glitches that will impact physicians, their practices, and their patients. New physicians who are finally in a position to participate - may not gain the benefits. This is like the first round when some states were ill prepared to set up such a program. Delays in payment changes are no longer rare and cut into revenue - the lifeblood of health care delivery.

We would never allow high tech to be suddenly practiced upon patients via high tech surgery or high tech medicines without substantial testing, assessment, and development. Even then there would be careful observation during implementation.

But we allow HIT or Health Info Technology to be implemented and promoted in a way that has resulted in complications and consequences.

This is not consistent with "Do No Harm" - the high standard that must remain the top priority for health care. In fact, the word reckless comes to mind with regard to such implementation.

The Hypocrisy of Health Care Cost Outcry

We have numerous articles on a daily basis that blame physicians for running up the cost of health care - while somehow not seeing that we spend more and more billions for software, hardware, sales force, Health Info Techs, consultants and others that add substantially to the cost of health care - costs that steal funding and support from the clinicians and teams and their time to deliver care

When revenue is taken from practices to pay for HIT, it can cause "glitches" or delays in the health care that can be provided. Sadly these may be most apparent for patients in most need of care.

Any hope for better health care for most Americans absolutely requires a top priority focus upon spending specific to the teams and clinicians that actually deliver the care rather than so many other areas - no matter how innovative or exciting they may seem.

HIT Is Not Yet Ready for Prime Time

Much more development, standardization, and study of HIT is needed. Interfaces, databases, and other areas should be standardized. Platforms are still used that will be gone in just a few years. Updates of software and various changes in national standards (Meaningful Use, ICD-10, billing changes) are not coordinated and almost seem strung out for maximal cost and minimal benefit.

No one should doubt the potential of HIT, but the potential may actually be retarded by full scale promotion and implementation focus.

This week is another announcement of another CMS delay/glitch. These have been far too common and have gone on for far too long. 

Information Technology Cannot Heal - Time to Get Out of the Way of Healing and Those Who Can Help Remove Barriers to Healing 

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Blogs indicate that primary care can be recovered and should be recovered.

Dr. Bowman is the North American Co-Editor of Rural and Remote Health. He was the founding chair of the Rural Medical Educators Group of the National Rural Health Association and the long term chair of the STFM Group on Rural Health.




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