Well, here are two very different views of an issue.  In one case there is optimism about the development of health information technology (HIT) and in the other, there is essentially an indictment of US HIT policy.  In the end, HIT systems that fail to carefully understand the needs and ergonomics of users – patients and physicians – will fail to achieve wide acceptance and will be doomed to short term success at best . . . obi jo

A special section about the use of health information technology (HIT) in the Dec. 19 issue of the Washington Post included a foreword written by AMA Board Chair Joseph M. Heyman, MD. In his comments, Dr. Heyman highlighted the AMA’s efforts to help physicians adopt new technology and shared the AMA’s optimism about the promise HIT holds for increasing patient safety and quality of care.

“Despite the complexity and cost of developing a secure, interoperable, nationwide HIT infrastructure, the AMA and physicians nationwide realize the transformative power that adoption of this technology promises for the future of patient care,” Dr. Heyman wrote. “As advances occur, HIT can fulfill its promise to help improve the quality and safety of patient care.”

New NRC Report Finds “Health Care IT Chasm,” Seeks New Course Toward Quality Improvement and Cost Savings

Like the Institute of Medicine’s (IOM) 2001 counterpart report, “Crossing the Quality Chasm,” a new report from the National Research Council of the National Academies is complex, full of new ideas assembled from multiple disciplines, and is likely to have seminal importance in framing public policy from now on. “Computational Technology for Effective Health Care:  Immediate Steps and Strategic Directions” was released last Friday, January 9, 2009 in draft, but there is so much to comment on that I think it’s wise to begin with a quote from the committee that sums up the central conclusion:

In short, the nation faces a health care IT chasm that is analogous to the quality chasm highlighted by the IOM over the past decade. In the quality domain, various improvement efforts have failed to improve health care outcomes, and sometimes even done more harm than good. Similarly, based on an examination of the multiple sources of evidence described above and viewing them through the lens of the committee’s judgment, the committee believes that the nation faces the same risk with health care IT—that current efforts aimed at the nationwide deployment of health care IT will not be sufficient to achieve the vision of 21st century health care, and may even set back the cause if these efforts continue wholly without change from their present course. Success in this regard will require greater emphasis on the goal of improving health care by providing cognitive support for health care providers and even for patients and familycaregivers on the part of computer science and health/biomedical informatics researchers. Vendors, health care organizations, and government, too, will also have to pay greater attention to cognitive support. This point is the central conclusion articulated in this report. (emphasis added)

It would be difficult to find a more sober indictment of US health care IT policy and implementation over the past decade than what is contained here.

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