As a taxpayer, my only regret is that in the Medicaid MU program, funds were handed out to doctors for doing nothing at all. The majority of Medicaid physicians I know signed up for a free EMR, took the first year $22,000, then did nothing thereafter. They never intend to use an EMR. And worst, the government incentives for Medicaid doctors is not over yet. More of our tax dollars going down the drain.

I would ask the question as well. Do the Scandinavians use ‘tech’ as much as we think we should?

Bob does not click the CPOE nor is he impeded by the CDS. Until he uses these poorly designed systems, be skeptical of what he states on EHRs.

“This change would allow EHRs to communicate with each other and developers to write apps that could link to the large systems like those built by Epic and Cerner. Promoting this kind of interoperability would be a judicious role for a smaller, less muscle-bound ONC, and for MU Stage 3.”

Good luck with that. Epic and Cerner will fight tooth and nail to protect their multibillion-dollar monopolies, even if it means dumping even more healthcare costs onto the taxpayer. Never mind that their fortunes weren’t build by the free market. They instead were built on the backs of the taxpaying public.

My first realization that this was a foolish idea was when we had our first upgrade of our EMR so it complied with Stage 1 of meaningful use. It became much less usable. I was mystified why they would make clinical care harder with a so-called upgrade. Only in retrospect do I realize that all of this happened because of the economics of meaningful use incentives in the marketplace: the venders realized that doctors were only buying systems that got them the money, so this was their sole focus. Since institution, vendors have responded to the marketplace, which does not reward improved care or efficiency, but pays handsomely for compliance.

The bottom line is that instead of transforming the system as a tool enabling efficiency and access to information, IT was transformed by the system into a tool to enable otherwise unreasonable data and documentation requirements to be done with a single click. Instead of making care more lean, IT allowed it to become a bloated boondoggle of data and documents.

The lesson I learn from this is that money trumps all. Until it is less profitable to do bad medicine, it will continue getting worse. Until we stop rewarding doctors, hospitals, and EMR vendors for treating patients as a commodity and not a customer, we will continue down this path. Anything less than radical change of financial incentives will have minimal impact.

Helps if I’d spell it right.

https://www.google.com/?gws_rd=ssl#q=interoperababble

This is why the SGR fix “everybody” (e.g. every significant health care lobby) has signed off on is bad policy: it imbeds MU incentives PERMANENTLY into Part B physician payment. No. No. No.

Google “Interoperabbable.” I coined the term. I currently own the above-the-fold search results. (I’d provide direct links, but THCB blocks mine.)