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Being John Glaser 1/20/09

January 19, 2009 News 5 Comments

In about a month, it is highly likely that our industry (healthcare information technology) will be very different. In my almost thirty years in this industry, there has never been an industry change of the depth and breadth that we are about to experience.

Last week saw the introduction of the first of the Congressional bills that will cause this change. These bills are part of a broader set of government efforts designed to stimulate the economy out of its distress. The healthcare IT portion of these bills intends to rapidly accelerate the adoption and effective use of information technology in healthcare. The House Ways and Means bill (PDF – go to page 138 and read from there) describes some proposed changes:

  • Provision of $40,000 in incentives (beginning in 2011) for physicians to use an EHR
  • Creation of HIT Extension Programs that would facilitate regional adoption efforts
  • Provision of funds to states to coordinate and promote interoperable EHRs
  • Development of education programs to train clinicians in EHR use and increase the number of healthcare IT professionals
  • Creation of HIT grant and loan programs
  • Acceleration of the construction of the National Health Information Network (NHIN)

All of these changes (and more) are accompanied by the infusion of $20B into the healthcare sector. To put this in perspective, in 2007 the HIT industry in the US was $26B (Gartner).

The “final” form of these changes is not clear. The Ways and Means bill and the Energy and Commerce bill and the Senate bills need to be reconciled. As I write (a snowy Sunday morning in Boston waiting for the NFL playoffs to start) I am sure that a wide range of industry professional associations, lobbying firms, and interested individuals and organizations are plowing through the language to identify improvements, concerns, and sections that need further clarity. Their voices will need to be heard.

And while the legislative process and discussion that arrives at a final bill will be (as it often is) complicated, confusing, and full of ups and downs, we should fully expect that sweeping changes will pass within 30 days.

What should you do about this?

First, to the degree that you have time, you should weigh in on the legislation. Your comments can be sent to your employer (if they are planning to provide feedback to Congress), your elected officials, and/or to industry professional societies (CHIME, HIMSS, AHIMA, AMIA, AHA, etc.) that will be providing feedback.

Second, get ready for an interesting 2009.


John Glaser is vice president and CIO at Partners HealthCare System. He describes himself as an "irregular regular contributor" to HIStalk.

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Currently there are "5 comments" on this Article:

  1. The last thing healthcare needs is for the government to throw money at healthcare technology — they will undoubtedly do so with accompanying requirements and the disaster will begin. We won’t replicate the UK model, but I’m sure it will be a mess nonetheless. The mess won’t be realized for a few years and, much to John Glaser’s disappointment, very little or nothing will change in a month. Perhaps he needs something to new to focus on — two years ago he was at HIMSS speaking in the Siemens booth on behalf of Soarian Financials. I’d love to hear how that project is going for them and his (honest) opinion of how it’s meeting his expectations for delivery and functionality.

  2. John,

    I have been following this closely like many in the Informtics community. I agree that 2009 is going to be a monumental point in time for the Healthcare IT community. I recently listed to the January 15th testimony of Jack Cochran (Executive Director The Permanente Federation), Janet Corrigan (President NQF), Valerie Melvin (Director of Information Technology The Government Accounting Office), Peter Neupert (VP Microsoft Health Solutions), Mary Grealy (President Health Leadership Council) in front of the Committee on Health, Education, Labor and Pensions. They outlined many of the bullet points above but also suggested utilizing some of the stimulus money to expand HIE programs and utilization of the massive amounts of data collected today.

    I personaly feel the bills in progress and stimulus needs to:

    1) Support the development of further Healthcare Information Exchanges through grants and incentives
    2) Reward organizations for achieving outcomes utilizing HIT as an enabler
    3) Support further development of interoperability standards and methodologies to harness the power of existing data we have today to improve outcomes
    4) Support the consumer through investments in Personal Health Record technology to reduce associated consumer costs

    It’s definetly going to be an exciting 2009, but one that many of us in the HIT community should be excited about!

  3. This really begs the question of what, exactly, will this money be spent on? Given the human resources needed to install and maintain HIT products, and assuming the market has already trained and given experience to the number of people who want to work in this industry, it seems that a lot of this money will be going into training efforts that cannot have a positive impact for several years. Or in other words, a lot of “certified” yet inexperienced people running a muck on projects forced through quickly since there was little business risk to the purchase.

    Or, the money will be used to further entrench the current generation of products that have been somewhat rejected by the marketplace as being poorly featured or overpriced (and most likely a combination of the two).

    The Nurse Informatacist offers a better solution. Use the money to support standards development, create facilities to transfer information, research & development on real, next generation solutions. And, throw a lot of money into the systems needed for a new paradigm for healthcare reimbursement – one not based on fee for service but based on real outcomes and results. And one that frees us from being welded to our employers’ decisions for our personal healthcare choices.

  4. Glasser really needs to find another world – he has continually been wrong on the assesments of this industy over the past five years, his technical appraoches and strategy have been misleading and fraught we recalcualtion. Isn’t it time to move on John?

  5. As someone who moved into Health IT from traditional engineering, I found the biggest issue is communication rather than technical. The subject matter experts such as a pharmacist believes they know a lot more about drugs than an engineer. Unfortunately even though this is true, the data has to be stored somewhere and accessed through an user interface of some sort.
    I think in order to make things successful, the gap between engineering and other subjects will have to be close gradually. The best way to do that is not to throw billion of dollars in training but rather enable universities to develop hybrid programs focused on both sides of the spectrum.

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