Curbside Consult with Dr. Jayne 9/10/12

Today is the start of National Health IT Week, which was created to “raise awareness about the power of health IT to improve the quality, safety, and cost effectiveness of health care.”

One of the events being held in conjunction with the festivities is a Blog Carnival. HIMSS invited bloggers to submit posts answering the question, “How will health IT make a difference a year from now at the next National Health IT Week?” Posts had to be submitted during the last month, and selected contributors will have their pieces appearing this week. I wasn’t confident that HIMSS would select anonymous bloggers for their showcase, so I didn’t bother to try. Plus I’m not much for deadlines these days since I’m getting pounded with work at my day job.

Another event will take place on the 13t, the Capitol Hill Health Information Technology Showcase. It is sponsored by the Congressional Steering Committee on Telehealth and Healthcare Informatics and will offer Members of Congress and staff “first-hand demonstrations of health IT and interoperable communications capabilities.” I was surprised to learn that this Steering Committee was founded in 1993. You would think if you had a bunch of lawmakers advocating for telehealth for nearly two decades, they would have figured out a way for providers to be reimbursed for providing it. If they haven’t been doing that, what have they been up to?

I surfed the Internet a bit and couldn’t find that they do much beyond organizing “widely attended educational sessions and healthcare information technology demonstrations” for Congress, legislative staffers, agency officials, industry, and the public. A different search revealed that the Committee is part of the Institute for e-Health Policy, which is part of the HIMSS Foundation. The Institute also sponsors a Congressional Luncheon Seminar Series funded by a vast array of IT vendors, insurers, hospitals, and government contractors. There was a smattering of quasi-nonprofit organizations on the list, but they may be there just for show.

In that frame of mind, I’d like to try to answer the question originally posed. Putting on my academic hat, it’s really a terribly worded question. It may have been more interesting if they added some qualifiers – such as how will health IT make a difference in a specific area? Or to patients? I’m admittedly in a cynical mood, but I’m going to have to say that I don’t think health IT is going to make any more of a difference next September than it does today.

Flash forward to September 2013. Vendors will be shipping out their “MU Stage 2 Compliant” releases to get customers ready to start attesting come January 2014. That means they will have spent the better part of the preceding year “teaching to the test,” or rather focusing their efforts on coding to the specs and achieving certification. Any innovation they had planned will likely be sidelined as they are forced to shift pre-defined blocks of resources to coding for MU goals rather than being revolutionary.

Customers will be readying last-minute upgrade plans and running full tilt towards the dual threats of Meaningful Use and ICD-10 mandates. Rather than focusing on clinical transformation and physician adoption, they will also be “teaching to the test” and training clinicians to make sure every nonsensical “i” is dotted and “t” is crossed. Providers will receive monthly (or worse, weekly) reports from practice and health system administrators that do nothing more than measure their performance on checking boxes.

Patient care will be largely unchanged. Rather than focusing on specific diseases or quality improvement projects, they will be scrambling to make sure they don’t lose revenue or get dinged in audits. Hundreds of millions of dollars will be spent, but clinical metrics will not be appreciably better.

Maybe it’s better that I didn’t submit for the blog carnival. I bet the chosen bloggers will paint a dramatically different picture. I can’t wait to see what they come up with.

E-mail Dr. Jayne.