Saturday, April 25, 2009

BusinessWeek on Health IT: "The Dubious Promise of Digital Medicine"

While I would have used the title "The Dubious Promise of Digital Medicine When Led By Amateurs in the Health IT Industry", the following Business Week article is one of the better and more realistic appraisals of the current state of Health IT.

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.

-- SS


Anonymous said...

Tullman's blatant disregard for the ideas of the brilliant minds who have published the truth about HIT and the industry is enough reason for Obama to dismiss him for violating his pledge to hear all sides. It is pathetic for this CEO and presidential advisor to resort to name calling to diss his intellectual superiors.

It is equally as pathetic for another CEO to call this the wild west land grab. And I suppose Neal thinks that the patients are prairie dogs.

Unknown said...

Just the idea that physicians are going to all the sudden adopt electronic charting because of the potential for some stimulus money is simply ludicrous. Physicians do not like change much, especially when it is mandated by the government. If docs need help navigating through the maze of red tape, Free EMR Solutions & Medicare Stimulus information can be found at Physicians are weary of security and functionality just like everyone else and they are going to be slow to jump on any bandwagon.