In response to Matthew DoBias' "Current state, future of RHIOs shaky: study":
Once again, free market principles demonstrate that even great expectations require significant capital investments to be fully realized. One must ask the question: Who stands to profit from electronic linkage of our populations' personal health information? Reductions in both medical errors and erroneous prescription drug orders would surely reduce complication rates, save lives and reduce healthcare costs. The elimination of unnecessary hospital admissions would definitely reduce costs, and shortened lengths of stay save money as well. Very likely reductions in hospital readmission rates would occur, also reducing costs. Bottom line: Based upon the organizations that serve to underwrite the cost of medical care, financial savings will accrue to the government, health insurance plans and/or employer groups. Consumers, of course, reap the benefit of receiving healthcare services that are truly medically necessary, within a decidedly improved healthcare delivery system that ultimately produces better patient outcomes.
Now, a limited number of providers, physicians and hospitals are presently investing significant capital to create local e-health networks. Some funding assistance is provided under so-called pay-for-performance contracts and other sources of financial assistance, perhaps in the form of supplemental grants. Unfortunately, in most cases, the carrot lacks the density necessary to fully support well-intentioned and thoughtfully designed e-health enterprises, and grants are more difficult to secure for smaller community providers. So providers continue to forge ahead in this regard. They lack the necessary financial support to truly devise optimal systems, but they do employ the reasonable intellectual judgment necessary to roll out first- or second-generation electronic health records and computerized physician order entry systems. Ongoing implementation compromises are made, at the local provider level, based upon funding considerations for the current or next phase of an e-health rollout.
So—very similar to our nation's long-standing debates with regard to healthcare access and the crisis in our public education system—we find a similar lack of uniform commitment from the public and private sectors. Each is failing to demonstrate a solid commitment to invest the capital necessary to build a vital, national e-health infrastructure. The federal government must step up to the plate, along with our nation's health insurance plans and corporate employer groups, to adequately fund local, regional and, ultimately, national e-health connectivity projects. Are there any concerns about potential waste and/or corruption in this regard? Just look at where our nation's current unfunded liabilities have been directed over the past six or seven years. I believe that our national debt has doubled within this span of time, now topping $9 trillion. No new taxes, eh? It's about time that we all took a good, hard look at reinvesting in America and, in particular, in America's citizens!
David Dubinsky
DirectorManaged careEmerson HospitalMaynard, Mass.Comment on news and share your opinions with other readers. Submit your letter to Daily Dialogue at [email protected] for possible publication. Include your name, title, affiliation, city and state. We reserve the right to edit all submissions.
