Friday, January 09, 2009

Who’s Who and What’s What in Health Information Technology

Prof. Bill Hersh, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University has drafted what I consider an important foundational document related to HIT initiatives by the incoming U.S. administration.

This document defines the "who's who" and "what's what" of personnel involved in Health IT.

His draft is at this link (pdf).

Dr. Hersh writes:

Health information technology (HIT) has become a hot topic! This is mainly because President-elect Obama has decided to include "computerization of health care" in his economic stimulus package. On three occasionals in the last month (Dec. 6th, Jan. 3rd, and Jan. 8th), he has personally stated the value of HIT both in improving health care and creating jobs. The Jan. 8th statement set a goal of all Americans having their medical records in electronic form within five years.

Dr. Hersh has drafted a document meant for policy makers and other that attempts to define all of the terms related to HIT personnel (the "who" and the "what") and put them in context. He believes it is important to get something "out there" before terms and identities of contributors and stakeholders become blurred or mangled.

I believe anyone interested in the improvement of healthcare through IT should be aware of this "ecosystem" of health IT enablers and facilitators.

In my opinion, if policymakers in Washington do not understand these basic fields and roles, let alone more complex and critical issues affecting HIT, we can almost be guaranteed that major difficulties will occur in any national HIT initiative the new administration might undertake.

This would be in part due to misallocation of leadership, management, design, and operational roles, and the resultant WWW Phenomenon (the Wrong people making the Wrong decisions at the Wrong time.)

-- SS


Anonymous said...

The unfettered deployment of HIT is a double faceted unregulated experiment, relegating all users and patients to being subjects without their consent, enabling the HIT device manufacturers to research and develop their devices.

The first facet is the unregulated use of these medical devices that have not been methodologically evaluated for safety and efficacy as recommended to HHS by Dr. Robert Califf in a CERTs memo of July 2004, nor approved for use by any regulatory authority.

The second facet of the experiment involves the alteration in the administration of medical care that already has been shown to cause more than 20 new mistakes, increased death in one published study, and neglect causing patient adversity.

What is of most serious concern is that there is not any formal after market surveillance.

To what authority should physicians and nurses report patient injury and death from the altered care or defects in the HIT devices? The FDA and the Joint Commission should be notified via their respective websites.

InformaticsMD said...

See my post today on the NAS press release on HIT.

-- SS