I've written about plans to scrap the Veterans Affairs Department's VistA electronic health-record system and replace I've written before about plans to scrap the Veterans Affairs Department's VistA electronic health-record system and replace it with a whole new EHR system built from scratch, jointly, with the military, but it bears repeating—that idea, building a whole new EHR system, was worse than nutty.
Taxpayers have invested billions of dollars in VistA. The development effort, started in 1977, produced one of the best EHRs ever, maybe the best.
I was personally introduced to VistA in 2003 by Dr. Louis Coulson, who graciously gave me a demonstration at the Jesse Brown VA Medical Center in Chicago.
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Professionally speaking, I am a connoisseur of a certain kind of crankiness.
I like to listen to people who don't like the deal we've been handed and are willing to grump about it.
Decorum may make the world turn smoothly, but noisy people make it change. Often, they also make my job more fun.
A lot of people in leadership pay lip service to the ideal that they're open to new ideas, but we all know from experience that many are not.
In the magazine this week are short profiles on four of the squeakiest wheels in healthcare information technology—three physicians and a researcher with a doctorate in sociology. They are Dr. Lawrence Weed, Dr. Scot Silverstein, Dr. Deborah Peel, and Ross Koppel, Ph.D.
Each are self-professed fans of health information technology, but each have bones to pick with current systems and practices.
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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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Privacy, security rule update coming soon—honest.
The Office for Civil Rights at HHS is about to release its omnibus final rule on health information technology privacy and security—this time for sure.
“Stay tuned,” said Leon Rodriguez, director of the Office for Civil Rights, in a recent telephone interview. His office is the chief federal enforcement agency of privacy and security rules under the Health Insurance Portability and Accountability Act, and the lead rule writer for HHS of the HIPAA privacy and security rule amendments required under the American Recovery and Reinvestment Act of 2009.
“Stay really tuned,” Rodriguez said. “I would really watch closely in the coming weeks.”
But haven't we seen this movie?
Back in March 2012, the civil rights office shipped off its ARRA-mandated privacy and security rule update to the White House for what was then believed to have been only a perfunctory once-over by its Office of Management and Budget before its imminent release.
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