While covering health information technology during the past 12 years, I've thought a lot about that warning against short-run overexpectations. I thought about that warning, again, reading a recent article in the Wall Street Journal, "A Major Glitch for Digitized Health-Care Records."
The authors, Stephen Soumerai and Ross Koppel, opine that it is "already common knowledge in the healthcare industry that a central component of the proposed health IT system—the ability to share patients' health records among doctors, hospitals and labs—has largely failed. The industry could not agree on data standards."
This is not the first criticism leveled at health IT promotion, nor the first by Koppel.
While I admire Koppel's earlier challenge to the orthodoxy that health IT produces only patient safety benefits, noting that it can introduce errors as well, this time he and his co-author could be likened to two guys watching a bartender making them mint juleps. They see only single shots of Southern Comfort in the bottom of their glasses and say, "My glass is empty." It's not empty, it’s just not a mint julep—yet.
While many hospitals and office based practices are now fully wired, in part because of the federal government's EHR incentive payment program, many still lag on EHR adoption. This whole conversion to health IT, to workflow and iterative improvement processes, to interoperability, and to privacy and security protection, remains in its infancy.
Interoperability is a failure only if your time line is too short and you begrudge the incomplete successes that are happening around us. E-prescribing, one form of interoperability, is soaring. In a couple of years, the federally sponsored Direct protocols will similarly become the method of choice for peer-to-peer communication, replacing the phone and fax machine. Even the far more complex query-and-response form of exchange is coming along. Earlier this month, the VA demonstrated a potential breakthrough in consent management technology for privacy protection using Direct and off-the-shelf standards from HL7.
"This is no time to go wobbly" on health IT, to borrow a line from Margaret Thatcher. The past and future public investments in health IT were—and will be—both proper and necessary.
Now is the time to execute and innovate—and, yes, to be watchful and even critical. But also, and maybe of the most importance, it's time to be patient.
Follow Joseph Conn on Twitter: @MHJConn.
