Intel's former CEO, EHR's for his horses, and Equus asinus

(Warning: animal-related metaphor alert!)

At this post I lamented the bull-in-a-china-shop intrusion into the domain of clinical IT by Big Business, focusing on Intel Chairman Craig Barrett's ill-conceived "prescription" for healthcare.

I thought I'd seen all the bull regarding such prescriptions.

However, in perhaps the most asinine [no pun intended] metaphor ever used in the domain of healthcare IT, Intel's former CEO Craig Barrett believes his use of EHR's for his 45 members of Equus caballus prove that EHR's for the 300 million or so members of Homo sapiens in the U.S. (and countless billions elsewhere) should be as easy as apple pie ...

... and that the magic bullet of "demands for change" from big employers will miraculously solve the myriad technical, emerging legal, and the nearly intractable sociotechnical, problems that have plagued clinical IT for the past several decades - and that have shown little sign of letting up, even in national-scale projects with massive budgets even larger than Mr. Barrett's wallet.

Intel Chief Repeats Call for Employers to Demand Change
By Neil Versel

July 24, 2007 | How dysfunctional is American healthcare? Craig Barrett, the well-heeled chairman and former chief executive of Intel has electronic medical records for the 45 horses on his Montana ranch, and even veterinary test results via e-mail for his equine friends. But the humans close to him have no such technology.

“I wish the average U.S. citizen had the same response my horses did,” Barrett said during an Intel-sponsored Webcast on chronic care management from Washington, D.C., last week.

... As Barrett has done many times before, he voiced his belief that change most likely will come from big business outside the healthcare sector. (See “Intel, Wal-Mart Call for Employer Activism in Demanding Health IT Adoption.”) “Systems only change rapidly when the people with the buying power demand the change" [i.e., threaten with economic bludgeoning -- ed.], the Intel executive said.

Horse manure is what I say.

When profoundly absurd comparisons of horse EHR's and human EHR's are made by people who apparently believe the size of their wallet trumps their lack of knowledge of issues that make human EHR's such a difficult endeavor, experts who do know better think of a different species:

Equus asinus.

Mr. Barrett, you are not helping healthcare with harebrained comparisons like this. In fact, through technologic determinism and suggestions of a generous application of economic bludgeoning, you are in my opinion making the situation worse, and postponing the day when there will be trusted, national, interoperable EHR's.

Of course, you ran a company that produced widgets, and probably dismiss the "soft issue" sociotechnical domain as fluff - issues that can be resolved through enough money, management consultants, TQM, process re-engineering, six sigma, balanced scorecards, and when all else fails, brute force. I'd be happy to let you take my course Sociotechnical Issues in Healthcare Informatics, but I doubt you'd want to; after all, your expertise in management and in the microprocessor business surely makes you a clinical computing expert.

I have some additional "soft issue" advice for you, Mr. Barrett. Perhaps you should not be bragging about your 45 horses on your Montana ranch. To cash-strapped hospitals that cannot afford EMR at the prices the health IT industry charges (e.g., Temple University in Philadelphia serving a large minority area of the city, that had to postpone plans to roll out an EMR), and to the tens of millions in the U.S. who apparently lack health insurance, such bragging might be interpreted along the lines of this infamous lady who at one point lost her head.

This was partly as a result of a rather insensitive line about pastries - something about letting the peasants eat cake.

(Perhaps Mr. Barrett's horses can talk, like Mr. Ed, and can give as complex a medical history as a human patient and opine on electronic health records as well):

A horse is a horse
Of course, of course
And no one can talk to a horse of course —
That is of course unless the horse
Has an equine EHR.

Go right to the source and ask the horse —
He'll give you the medical history that you'll endorse
He's always on a steady course
The horse has EHR!

People yakity-yak a streak
And waste your time of day,
But a horse will never speak
Unless he has something medical to say!

A horse is a horse
Of course, of course
And this one will complain about EHR privacy 'till his voice is hoarse
You never heard of a talking horse?
Well listen to this:
"I am a horse with EHR!"

-- SS