VA is a much more complicated rollout since there are so many different interactions and configurations of VistA. In addition,…
An Alternative Plan for $20B
The congressional discussion around the $20B HIT investment is rapidly drawing to a close. However, there may still be time to discuss an alternative investment approach.
Rather than financial incentives for physicians and hospitals, education of HIT professionals, and other current ideas, I came up with the following.
For Healthcare Providers
There are something like 4,000,000 physicians, nurses, and other allied health professionals. For each of them, we would get:
- 3-D goggles. These goggles will improve EHR usability and hence we’re more like to see high levels of e-prescribing and other important EHR uses. I would suggest that we get high quality goggles; not the Super Bowl cheap kind. 4,000,000 providers x $30/quality goggle = $120,000,000.
- iPhone. Again, to improve ease of use and also provide some cool software (including a GPS so they know where they are in the hospital) I would get all providers an iPhone. 4,000,000 providers x $200/iPhone = $800,000,000.
- EHR baseball caps. So their patients know that they are all on the EHR team, we would get all providers an EHR baseball cap with a fancy EHR logo. 4,000,000 providers x $12/cap = $48,000,000.
For HIT Professionals
I think (without facts) that there are something like 200,000 professionals who will be involved in EHR implementation and support. For each of them, we would get:
- Oscilloscope. This will help troubleshoot EHR problems and configure the software. 200,000 professionals x $1,200/oscilloscope = $240,000,000.
- Soldering gun. They will also need a soldering gun to fix any problems they find. 200,000 professionals x $200/soldering gun = $40,000,000.
- Trinkets. All of these professionals will go to HIMSS to hear talks and see what’s what in the exhibit hall. Since we want them all to get high quality exhibit hall trinkets, I am proposing that each attendee get $1,000 worth of trinkets. 200,000 professionals x $1,000 worth of trinkets = $200,000,000.
- Infrastructure. To connect all of these EHRs, we will need an EHR satellite. 1 satellite x $1,000,000,000/satellite = $1,000,000,000.
We should do something for patients since this really is about them. I had initially thought that we’d get everyone in this country an electronic stethoscope that could be connected to the satellite, but with only $20B, we can’t afford it. 300,000,000 people in the US x $300/stethoscope = $90,000,000,000.
We have $17,552,000 left to spend. This is approximately $60/person.
Since it will take some time to launch the satellite and manufacture and distribute goggles, caps, trinkets, etc. and since we want everyone to take better care of themselves soon, I would get each person in this country:
- The AMA Family Medical Guide at $30 each
- A Deluxe Pilates Exercise CD at $30 each
And that’s the alternative plan. Some of the estimates of healthcare professionals and EHR staff may be low, but I am also sure that we could get a bulk deal on the items above and still stay within budget. We may not be able to get a deal on the satellite.
John Glaser is vice president and CIO at Partners HealthCare System. He describes himself as an "irregular regular contributor" to HIStalk.