Thursday, February 12, 2009

Another Human Bites Dog Story? Health Affairs Briefing on Healthcare IT Challenges

I recently received the announcement below. It announces a briefing to herald the release of a new edition of Health Affairs dedicated to healthcare IT.

The key phrase is this:
At this crucial moment [in healthcare IT] , Health Affairs devotes its forthcoming March-April 2009 issue to health IT—its transformative promise, but also the challenges to its adoption and the substantial dangers it could pose if that adoption is not done right. The issue will be released at a briefing on Tuesday, March 10, at the JW Marriott in Washington , D.C.

/Semi tongue-in-cheek tone ON

Substantial dangers from Health IT? Dangers as in - possible adverse effects? I'm stunned. Who knew?

... This sounds a lot like what I've been writing and taking heat for, for the past ten years:

While clinical IT is now potentially capable of achieving many of the benefits long claimed for it such as improved medical quality and efficiency, reduced costs, better medical research and drugs, earlier disease detection, and so forth, there is a major caveat and essential precondition: the benefits will be realized only if clinical IT is done well. For if clinical IT is not done well, as often occurs in today’s environment of medical quick fixes and seemingly unquestioning exuberance about IT, the technology can be injurious to medical practice and biomedical R&D, and highly wasteful of scarce healthcare capital and resources. Those two short words “done well” mask an underlying, profound, and, as yet, largely unrecognized (or ignored) complexity.

The reason I call this story another possible "human bites dog" scenario (the first being here) is due to the speaker's list below.

Who knew?

Who knew that companies and foundations such as Cerner and Microsoft and Markle and Google acknowledged and embraced the concept that health IT could pose substantial dangers if adoption is not done right?

I certainly didn't. The press releases and seminars I attended by those organizations and the articles and advertisements I saw in journals always seemed to present HIT as a magic bullet, a panacea, a cybernetic miracle with no downsides, a plug and play solution to healthcare's ills.

I ponder this: a Google search on "Healthcare IT Failure" or similar concept turns up my web site and a few other writings on this issue, but precious little from the likes of Cerner, Microsoft, Markle, Google Inc., etc.

Google's search engine must be wrong! It's not listing all the links from these organizations going back years on the possible dangers of ill conceived and poorly implemented HIT. Someone call the Googleplex!

In fact, I authored an AMIA poster in '06 on this curious phenomenon, that search engine queries on the concept of healthcare information technology failure (a form of IT misadventure or IT malpractice) returned my website and writings and a few others' work, while a search on "medical malpractice" returned tons and tons of relevant hits:

Access Patterns to a Website on Healthcare IT Failure. AMIA 2006 Poster. Abstract [pdf], Poster [ppt].

(Even at AMIA the word "failure" in the same sentence as "Healthcare IT" did not seem to go over well, and the site now wears the term "difficulty" instead of the "F" word.)

When I spoke to representatives of some of these organizations about my work and similar work of others studying HIT failure, I received disdain at best, and at worst the response was as if I had lost my senses - or something.

Maybe these organizations were just afraid to tell me ten year's work was simply redundant, as their leaders -- through critical thinking, scholarly examination of the evidence, and candid corporate wide discussion -- had discovered these issues years before.

There are some known candid speakers at the briefing as well. The announcement is below:

Save The Date: HEALTH AFFAIRS Briefing

Stimulating Health Information Technology
Tuesday, March 10, 2009 – Washington , D.C.

There is widespread agreement that greater investment in information technology (IT) is critical to reforming U.S. health care. The use of such technologies as electronic health record systems, personal health records, e-prescribing, and computerized physician order entry holds the potential for vastly improving care at reasonable cost. Debate is now under way in Congress over how much to invest in health IT as a component of the economic recovery, or stimulus, package now being developed. The likelihood is that major public and private investments in the sector now lie ahead.

At this crucial moment, Health Affairs devotes its forthcoming March-April 2009 issue to health IT—its transformative promise, but also the challenges to its adoption and the substantial dangers it could pose if that adoption is not done right. The issue will be released at a briefing on Tuesday, March 10, at the JW Marriott in Washington , D.C. At the briefing, speakers will discuss the public policy issues surrounding health IT, particularly those raised by the health IT provisions in the stimulus package. Speakers will also discuss pioneering health IT initiatives, the privacy concerns raised by health IT, and industry health IT innovations.

The briefing and the new Health Affairs issue are supported by grants from the Markle Foundation, the California HealthCare Foundation, and the federal Agency for Healthcare Research and Quality.

Here are the details:

WHEN: Tuesday, March 10, 2009
9:00 a.m. – 12:30 p.m.
WHERE: JW Marriott [Metro Center]
1331 Pennsylvania Ave., NW, Washington, DC 20004

RSVP: RSVP for this event online at . For more information call Staci Gorden at 301-652-1558.

SPEAKERS: Carol Diamond , The Markle Foundation
Linda Dimitropoulos , RTI International
Colin Evans , Dossia Consortium
Louise Liang , Kaiser Permanente
Deven McGraw , Center for Democracy and Technology
Farzad Mostashari , New York City Department of Health
Peter Neupert , Microsoft Health Solutions Group
Neal Patterson , Cerner Corporation*
Deborah Peel , Patient Privacy Rights Foundation
Eric Schmidt , Google Inc.*
Mark Smith , California HealthCare Foundation
James Walker , Geisinger Health System
Jonathan White , Agency for Healthcare Research and Quality

/Semi tongue-in-cheek tone OFF

I conclude by wondering exactly what's caused some of these HIT cheerleaders to "get religion" about the possible dark sides of health IT.

The possible change of heart on this formerly proscribed topic puzzles me.

-- SS


Anonymous said...

hmm it would be nice to know who wrote this blog entry? I assume frequent readers know who SS is but context is always helpful to new people. I assume that you are confidential for a reason so I will be also lest I become linked to this post.

InformaticsMD said...

My contact information is in my blogger profile which is linked via the "contributors" in the right column.