Give RAND Corp. researchers Arthur Kellermann and Spencer Jones a gold star for integrity for pointing out the predictions in a totemic 2005 RAND report haven't quite panned out yet.
Their latest analysis of the value of health IT, published in the January edition of Health Affairs, notes that the billions of dollars in annual savings from the adoption of health IT systems projected by RAND peer Richard Hillestad in 2005 haven't materialized.
The Hillestad study was often cited by EHR advocates, including a few federal legislators, as an economic argument for promotion of health IT.
What seems to be getting lost in some recent news reports and follow-up discussions about both RAND reports, however, is that while the predictions of Hillestad and his team “have not yet come to pass,” it is not because their cost-savings projections were flawed, according to Kellermann and Jones, but rather because of “sluggish adoption of health IT systems,” EHRs that are “neither interoperable nor easy to use,” and providers who fail to re-engineer their care process to best leverage the IT systems they have.
Some analysts have interpreted Kellermann and Jones' report as RAND crawfishing.
Hillestad, now retired, says he has been keeping up on the controversy and is standing firm.
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This year, it seems, the Healthcare Information and Management Systems Society is taking a more subtle approach to lobbying for privacy and security regulation.
During its annual Health IT Week lobbying push earlier this month, HIMSS presented just three "asks" to Congress. Two dealt with privacy and security issues.
One asked legislators to study patient identification. A two-page letter from HIMSS spent a lot of verbiage discussing the history of a national patient identifier and how Congress has, since 1999, banned federal funds from being used to "promulgate or adopt" one.
Nonetheless, HIMSS is looking for wiggle room.
Its statement pondered whether studying a patient identifier is verboten, then postulated that a "lack of clear congressional intent . . . poses a huge impediment to the optimal adoption of health information exchange."
That's a slight softening of focus. In 2006, HIMSS and another organization it helped create, the National Alliance for Health Information Technology, pushed for a national patient identifier.
In another "ask" this year, HIMSS is lobbying Congress to support "harmonization" of federal and state privacy laws—again, an apparent softening of its position.
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