Sunday, August 19, 2007

Change in Direction

For the past three years I have been beating the drum about the development of HIE and RHIOs. I have not come to any final conclusions about the destiny of this "visionary" prospect. There are a great deal of positives and negatives regarding HIE and EMRs.
I will deal with some of the negatives first.

1. Most providers complain about the complexity and bureaucracy of practicing medicine, in regard to regulatory requirements, the hurdles of reimbursement, and exponential increases in business overhead.
2. The burden of Health IT may outweigh the benefits.
3. HIT is very expensive
4. Automation and the impersonal nature of IT does not really fit in to the paradigm of medical care. Despite patient enthusiasm for all things technical most providers are reluctant to introduce an infrastructure that will make them dependent on third parties.
5. Most physician providers operate on the basis of accountability, reliability, and a one on one relationship with each patient. IT is not going to improve the patient relationship.
6. Medical care has always been a unique portion of our economy, and recently outside forces have forced change, some good, and some very detrimental to patient care.

1. The introduction of web 2.0 has greatly expanded patient education, and allows patients to ask more relevant questions.
2. Web 2,0 also introduces transparency and allow for "error checking" on the part of patients
3. Web 2.0 also increases the providers outreach for reliable information instantly at the point of care.
4. Most providers who have installed EMR speak positively about having it, and "would not go back to the old system" (my comments are that they could not even if they wanted to, because of their heavy investment in the system.

That's my meager summary after three years, it is not all inclusive.

Beginning next week Health Train Express will change direction. Look for a change in content first, then a change in the front end. I hope to maintain the title "Health Train Express" however our domain name may change.
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