In an open letter blog to President Obama, Burton Group Senior Analyst Joe Bugajski opines that President Obama is spewing “delusional visions of a nation-covering, interoperable, secure, private, reliable, accurate, and instantaneous electronic healthcare data network is at best terrifying and at worst pernicious.” OK – I had to look up ‘pernicious’. It’s not good.
Mr. Bugajski goes on to relate a horrifying personal experience in which he ended up in a clinic and then a hospital that both used electronic health records. He relates the story of his stay in which electronic health records hindered rather than helped and concludes that most health care professionals “longed for handwritten charts hanging at the foot of every patient’s bed.” While I don’t doubt his experience, and I disagree that building a national health information network is an unsound idea. In fact, the National Health Services (NHS) in the UK is several years into its ‘Connecting for Health‘ program and has already built a nation-covering, interoperable, secure, private, reliable, accurate, and instantaneous electronic healthcare data network. The UK is reaping the benefits of improved treatment and cost savings. You can read additional background in my research note, Toolkit: Enterprise Architecture for the U.K.’s National Health Service (Case Study)
Mr. Bugajski is correct that the initiative will be large and costly and I also agree that the US government should approach the program with caution. But the benefits are enormous – it’s about saving lives! While I sympathize with Mr. Bugajski’s unfortunate experience, I believe moving forward on this initiative is truly one of the bright spots in President Obama’s stimulus plan.
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Point taken: the UK’s NHS Programme for IT presents a wonderful vision. So does the US version. Point contested: the “UK is reaping the benefits”. Unfortunately, serious challenges persist in the UK at the scale noted in my ealier post.
Richard Woods (“Darling swings the axe”, The Sunday Times, April 12, 2009, http://www.timesonline.co.uk/tol/news/politics/article6078496.ece) wrote, “Or take the grandiose plan to create a central NHS computer system. Originally budgeted at £2.3 billion, it is now expected to cost £12.7 billion. It is years behind schedule, may never work as promised and is seen by many doctors as a waste of money.” In an earlier article, The Sunday Times’ Jonathan Ungoed-Thomas and Lois Rogers reported their concerns with the massive NHS IT programme (“Focus: Anatomy of a £15bn gamble”, April 16, 2009, http://www.timesonline.co.uk/tol/news/uk/article706148.ece?token=null&offset=0&page=1). This despite IT being run as a national service. Contrast that situation with the US where HIT is fragmented and the IT systems highly variable even within the same organization.
It would be wonderful if HIT could deliver President Obama’s or former PM Tony Blair’s vision. It would also be wonderful if HIT was about “saving lives”. Tragically, the opposite may be true. Poorly implemented HIT can kill (e.g., see Dr. Scot Silverstein’s posts, http://www.ischool.drexel.edu/faculty/ssilverstein/failurecases/).
While a national HIT network may someday deliver “life-saving” technology, achieving that vision will be a long, expensive journey that requires a renewed emphasis on user interface design and data engineering fundamentals.