None of the writers attacked me personally—thank you, gentle readers—but several well-wishers pointed out that I should have mentioned an accompanying commentary about the study written Dr. Clement McDonald and Dr. Swapna Abhyankar. As most IT readers know, Dr. McDonald is one of the nation's pioneering and pre-eminent medical informaticists.
My response to them and to you is, oops. I had the pleasure of meeting Dr. McDonald some years ago in Indianapolis when he was with the Regenstrief Institute, and I would have mentioned his analysis had I seen it. To make amends, here's the link to Dr. McDonald's and Dr. Abhyankar's commentary.
That said, seemingly heretical writings by members of the IT community are nothing new. Readers will recall the flap nearly six years ago when Dr. Ross Koppel shocked and mortified some IT true believers by writing that computerized physician order entry at a hospital where he worked wasn't all it was cracked up to be.
Nor are these criticisms all confined to ancient history.
In the 30 or so comments we received about the Stanford story, including several to me personally, readers were fairly evenly divided on whether the government's hard push toward EHR adoption and meaningful use is a good thing or bad thing.
Many writers took the side of Stanford researchers Dr. Randall Stafford and Max Romano, but many did not.
One physician wrote: "Thanks to Stanford University's research team for having the courage to stand up to the giants and touching on a subject that many of us have been concerned about since the advent of computers in healthcare."
Another commenter said: "It doesn't make sense to draw such conclusions from a single medical-center experience. Multiple studies looking at quality measures have shown two healthcare systems rank at the top nationally. One is the Department of Veterans Affairs (where I work) and the other is Kaiser. Both attribute their success to early and universal use of EHRs."
The U.S. is embarked on a massive, disruptive and costly transformation in adopting EHRs. Whether we're moving too fast is arguable. Whether it's prudent to pour billions of dollars into incentive programs to kick start EHR adoption or whether it would be better to allow the market to build demand for EHRs is similarly debatable.
I believe it's a good idea to embrace further research as EHR adoption proceeds. There is doubtless much we'll learn in the years ahead about these systems, how best to introduce and use them in the healthcare workplace and what's best to do with the data they collect and share.