Monday, May 18, 2009

Healthcare IT Timing "Cemented in Law?" A Healthcare Renewal Contest

I am quoted in the article "Liability an issue with health care software" in today's online edition of (link to article). is part of the National Journal Group Inc. and the Atlantic Media Company. It is a spin off of Government and provides coverage and commentary on the management of information technology in the federal government.

Read the whole article. I reproduce a part of it below for the purposes of sponsoring the first ever Healthcare Renewal contest.

The rules are simple. Add to the blog comments section your best explanation of the interesting phrase in the last sentence of the excerpt, bolded below. The best comment will get an honorable mention appended to the text of this posting.

Keep in mind that the laws regarding health IT appeared in H.R. 1 EH, a.k.a. the Economic Recovery Act of 2009, with little or no public discussion regarding incentives, penalties or timing. See Div. B Title IV, Health Information Technology (Word file extract of a version of the bill from a few months ago) to review the Act's text on HIT.

With that in mind, here is the excerpt:

... Health IT provisions in the economic stimulus package are integral to Obama's overall health care agenda, and give doctors and hospitals incentives to adopt certified electronic records by 2014. The Recovery Act appropriates about $20 billion in Medicare and Medicaid incentives to meet that goal.

Professionals who deploy certified electronic health records between 2011 and 2014 will be eligible for Medicare bonus payments, while hospitals that implement certified e-records by 2015 also will get bonuses.

Scot M. Silverstein, a medical informatics consultant, adjunct professor at Drexel University and former director of Drexel's Institute for Healthcare Informatics, said the timeline for adoption should be extended. Starting in 2015, the administration plans to dock Medicare payments for professionals and hospitals that fail to use certified e-records.

"I think the punitive aspects that kick in need to be eliminated," Silverstein said. "I think the government needs to re-examine its justifications for shoving IT down doctors' throats by 2014."

David Blumenthal, Obama's national coordinator for health information technology, said the government will tighten oversight of the certification process to address such concerns.

"Right now, we are reviewing that process to see how it can provide stronger guarantees that [products] will perform as they are promised to perform," he said. But the timelines for rollout of health IT are cemented in law, he noted.

"Cemented in law?" Your comments, please.

-- SS


David Smith said...

So many quotes come to mind - I've worked on several IT projects with finish dates set by legislation before they began - with predictable results. I think the most apropos is "The way you make G_d smile is to tell Him what you'll be doing next week."

Anonymous said...

With apologies to Rousseau:

Laws are the cement that hold together a civil society.

Steve Lucas

InformaticsMD said...

It seems that laws that sprung out of "nowhere" can be changed just as easily? We're not talking the 11th commandment here, no?

-- SS

Anonymous said...


LOL Really good.

Steve Lucas

Anonymous said...

It was a misspeak. He meant to say that the "timelines for rollout of health IT are cemented with flaws." (in the devices). Don't buy. don't buy, don't buy. don't buy.

Jay Andrews said...

Introducing a must to move to Electronic medical records for all the doctors will help the US medical professional to access the data from remote location.

InformaticsMD said...

Jay Andrews said...

Introducing a must to move to Electronic medical records for all the doctors will help the US medical professional to access the data from remote location.

Ideally, yes.

And we don't need the Space Shuttle. We can merely use far less expensive hot air balloons to go into space.

Oh wait ... it's not quite so easy... there are complications...

That being the point of all my posts here on HIT.

-- SS

Dan said...

Great post I've read here.

cemented in law means essentially coercion through reinforcement techiques. Systems and rules are being implemented in this administration to assure more adopt EMRs. If not, these others will be ostrasized by loss of income.

A health care agenda should not be an economic stimulus package. This concerns me. The health care system in the U.S. is in need of overhaul, and not further corruption, or potential corruption of this system.

Seems like every new administration in the U.S. attempts to stimulate our country's economy by manipulating an aspect or business element that has been viewed historically as financially insignificant so few others will financially gain. During Regan's administration, it was the Bayh/Dole, and the savings and loan scandal, for example.

Monetary savings from EMRs is, in my opinion, speculation. Any who have concluded that EMR implementation equates with ROI is formulating a false conclusion.

The big IT corporations will thrive due to what has been cemented in law, and possibly some medical institutions. Health care will not be improved by EMR implementation, in my opinion.

Thanks for what you share on your blog,


Robert Crausman said...

Cement shoes were a specialty of the Gambino family and were a euphemism for "sleeping with the fishes." My guess is that the Obama administration is making us an offer we can't refuse.

Andy Stones said...

I agree with Robert Crausman that the bill which has been passed by the senate for EMR is really an encouragement for all the doctors who are not used to emrs.

InformaticsMD said...

There is a difference between social engineering encouragement by carrot, and encouragement by carrot and stick.

The latter is more typical of autocratic governments.