Business Week, April 23, 2009
The Dubious Promise of Digital Medicine
Chad Terhune, Keith Epstein and Catherine Arnst
Recommended reading for anyone interested in improving healthcare via information technology. (Full disclosure: MedInformaticsMD was a contributor to the article.)
I will be commenting in upcoming posts on the article's points and HIT industry's customary, self serving and unscientific counterpoints. The article's thrust is that a HIT remains an experimental technology with a mixed history, which like any societal-level experiment (HIT representing a form of social engineering) carries individual and public risk. The risk is that when misled, any social experiment can and will lead to serious unintended consequences, which in this case ultimately means patient harm.
The first counterpoint that struck me in the article was this one:
Allscripts CEO Glen Tullman [a non-clinician businessman and an advisor to the Obama campaign on HIT] ... compares the skeptics of health info tech to doctors who questioned the introduction of the stethoscope in the 19th century: "There have been Luddites in every industry."
This profoundly unscientific, ad hominem dismissal represents the poster example of what I call a cross-occupational invasion of medicine by the IT industry. The attitude represents the antithesis of medical and scientific culture.
It simpy dismisses with a wave of the hand a growing body of authoritative literature going back decades. A small sample of that literature can be seen here, and anyone in HIT is grossly negligent to dismiss, or worse, not to be aware of such findings. There's really not much more to say on this issue.
This is an example of the attitudes of HIT industry leaders who believe they will "revolutionize" medicine via IT. Health IT with appropriate leadership can do quite well for healthcare. In the wrong hands, I'm sorry to say, the opposite is true.
It is, in fact, Mr. Tullman and like minded others in the IT industry, who make similar statements about those with the ultimate responsibility and liability for patient care, physicians (as Koppel and Kreda point out, the vendors have none), who are the Luddites. They are Luddites through their dismissal of the best thinking in modern IT and in biomedical information science.
On second thought, it might be more accurate to say they leverage their Luddism and willful ignorance in an opportunistic manner. Caveat emptor.