Is the HIT industry the auto industry of health care?
Yes, says Dr. Rick Peters at the Health Care Blog:
The health care information technology (IT) industry is a close analog of the auto industry circa the 1970s. A few large players who build big, expensive systems on outdated technology platforms dominate the industry. There are some Toyotas, Hondas, VWs, and BMWs in the mix, but the big players dominate the industry forums, standards organizations, and mindshare of the institutions – our academic medical centers and large health care organizations. They sell the institutions Cadillacs and Lincolns with big fins that wallow and weave as you drive down the road and they offer the rest of us Pintos and Vegas – smaller versions of the big systems that unpredictably catch on fire.
Unlike other industries, however…there is a peculiarity to health care IT relative to government regulation. The large health care IT companies love regulation and they love government mandated standards. You might wonder, no other industry has government setting standards, why health care?
It’s simply because HITSP [Healthcare Information Technology Standards Panel] and ONCHIT [Office of the National Coordinator for Health Information Technology], the organizations set up by industry and the government to mandate standards, are controlled by the large archaic systems vendors. Standards selected and set by these organizations are unnecessarily complicated, expensive to implement, and protective of the big players. They stifle innovation and like the Big Three automakers, keep health care IT completely out of step with the general computer industry. Health care IT and HITSP standards are at least a decade behind the open data standards and open-source progressivism of the general computer industry.
In a nutshell, do not pour more money into this industry without completely rethinking how we drive innovation. Currently available EHRs from the major, CCHIT certified vendors will not save us money. Any assumptions about improvements in quality or patient safety will be offset by an across the board loss of clinical efficiency, a loss of productivity and a counterintuitive increase in the number of personnel, and increased clinical and administrative errors due to system and user interface complexity.
I agree that we don’t need an HIT “bailout”. We also don’t need government or private insurance company mandates on physicians and hospitals to adopt technology that is not yet mature. The third party payors want health care providers to adopt HIT, however crude it may be at present, to benefit them (i.e. the third party payors). HIT just plain isn’t “there” yet and will not be for a number of years. Let the early adopters and the industry tinker with the technology for another decade or so.