Larry Weed 101 — see “Medicine in Denial”

“People quite senior in the administration – even the White House – knew of safety incidents involving “Certified” EHRs and chose to downplay them in the name of “progress”
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Document that. Name names. Cite/link actual statements.

http://www.blogtalkradio.com/healthtechmedia/2015/02/25/meet-robert-wachter-md

I have to say that I’m a little in all three of Mr. Holt’s camps:

– HITECH was sold to Congress based on lies (the now disproven Rand report) and the environment of the time (new presidency, ACA battles, focus on stimulus, need for “success” of HITECH) led to some short-sighted and politically motivated decision-making and steamrolling of doubters (i.e. people raising concerns about safety, interoperability, usability, fitness of vendors, etc.) People quite senior in the administration – even the White House – knew of safety incidents involving “Certified” EHRs and chose to downplay them in the name of “progress” (however illusory it was).

– As stimulus HITECH had to be based on the legacy products available in the marketplace (as bad as they were/are) at the time. Vendors lobbied HARD to ensure that they didn’t need to make fundamental changes to inherently proprietary, non-interoperable products. Again, “progress” depended on it. ONC’s FACA’s chose to focus on the trivial many for Certification vs. the really important few (e.g. a standard data model, foundational interoperability standards for critical use cases, usability testing / use of standard colors and icons in products). Will incremental progress take place? Sure. Will the real breakthroughs to say, 21st century technology platforms, truly usable, interoperable systems that docs and nurses don’t hate happen? Not if the oligarchs (Epic, Cerner) can help it.

The real question is: What is the path forward?

Ron

“everyone voluntarily and gladly used it.”

For EHR’s to progress at the optimal rate, all the mandates, incentives, subsidies, rewards and penalties….all administered by bureaucrats seeking to coerce implementation for their own ends (not the ends patients and doctors want)…..should be lifted. Then the focus of all investment would shift to creating systems that patients and doctors would clamor for.

Agree. Docs should just do what they’re told and keep their mouths shut. Who told them they were allowed to have opinions?

“before there was the iPad, there was the Newton; before there was ubiquitous wireless connectivity, we suffered the screeches of the dial-up modem”

Terrible, terrible analogies. It was obvious that the Newton was a lemon and, like EMRs, nobody bought them. There was no government subsidy or requirement to use them, so they quickly disappeared. And, at the time, we thought dial-up was fantastic. It looks bad in retrospect, but it was an undisputed improvement on what we previously had, and everyone voluntarily and gladly used it.