The original article meant “agile” in the lowercase, dictionary definition-sense of the word, not Agile.

You will have a triad of special interests to deal with…how well that triad is MANAGED will be the chief determinant of success in the HiTech funding program.

The three stools of the triad are: The president’s healthcare agenda and funding will expect, demand and supposedly incent ONLY successful results; second, EMR vendors, with special interests in their products (over 300 of them!) will lobby hard for the same CCHIT-type certifications (that they have paid dearly to follow the blueprint for) that are having well-documented adoption problems for well-documented reasons; and physicians, such as Dr.Borges, above, representing so many providers, who say existing EMR will NOT be the answer for the BROAD market. It CAN’T be because it makes physicians data entry clerks and slows them down during exams. Incentives won’t change that

Only two solutions to this conundrum: Force physicians to “get over it”, learn the EMR’s as they are and accept whatever consequences to their practice; OR, force the EMR’s vendors to comply with not only a functionality standard, but a “usability” standard that compares how long it takes to accomplish key tasks during key parts of medical visits.

To see how the latter would work, look at Hybrid EMR…which was borne of the need for EMR for high performance or high volume practices. HUGE success rate. Usability is the key component in hybrids.

Without “usability” in the mix, $20 Billion could be wasted!

The same short iterative development cycles we utilize in IT are similar to the quality cycles utilized in health care but you rarely find someone who is skilled in both.

Now if only we could get some of the major EMR vendors (or new players) to use Ruby (the language) on Rails (the framework) (RoR) combined with an Agile web development model

Nice to see the possible future ONC chief of staff sharing his expertise from in the trenches.

shhh. I am incognito today.

I’m not sure what you meant by that, but the way I’ve seen things is that CCHIT certification is not about standards as much as for “culling the competition field”, for increased complexity, and for increased costs. This complexity results in less change, more installation failures (~50% in most series), and overall are not wanted and are not being bought by physicians.

John- what’s the status of your joining in with Obama’s cabinet? Is that true? That would be great; I don’t always agree with you, but you seem like a reasonable guy.

If so, can you try to reprogram our emperor, dictator, president, Lincoln-wannabe, Castro-with-a-tan, or whatever you wish to call him that forcing HIT onto physicians is not going to work, and will result in increased costs, increased errors, decreased quality, and with a Medicare system devoud of doctors? Thanks!

Al