Health IT

I think this is a really good description of the current practice of EMRs
in the US (and what could potentially happen in other countries), it
describes how the power in the EHR has gone more into the industry than the
clients (hospitals or other clinical institutions), and I agree that for
some reason there has been little innovation in the creation of these
systems, where legacy systems literally 30-40 years old are some of the
most prominent EMRs out there.

I remember that one Venture Capitalist in the health IT field mentioned
that 70% of costs for a health IT startup where marketing and sales, I
think that is part of the explanation for the situation.

Joaquín
___________________________________________________________________
Gerente de Desarrollo, eHealth Systems <http://www.ehs.cl/>
Research Fellow, Escuela de Medicina de Harvard <http://hms.harvard.edu/>
Moderador, GHDOnline.org <http://www.ghdonline.org/>

The diverse responses to this provocative article have echoed around the world. The components of the quotation above do carry a sense of “them (vendors) and us (health informaticians)”. This would seem to perpetuate the continuing “ill-health” of health reform that exists in essentially every country. A clear cut answer is that “we are in this together” for the betterment of our peoples and economies. On the latter point ex-President Bill Clinton described the situation clearly. “All our efforts to strengthen the economy will fail. Let me say this again, I feel so strongly about it. All our efforts to strengthen the economy will fail unless we also take this year, not next year, not five years from now, but this year, bold steps to reform our health care system.” President Clinton in remarks to Congress (Wall Street Journal November 3, 1993, p1). We know health is unaffordable and we know the previous “business models” have not resolved the information management problems in health care so we need to begin to design systems that resolve the problems surrounding the direct patient care processes. That is the failure of the human mind to cope with the complexity of the modern health ...

The diverse responses to this provocative article have echoed around the world. The components of the quotation above do carry a sense of “them (vendors) and us (health informaticians)”. This would seem to perpetuate the continuing “ill-health” of health reform that exists in essentially every country. A clear cut answer is that “we are in this together” for the betterment of our peoples and economies. On the latter point ex-President Bill Clinton described the situation clearly. “All our efforts to strengthen the economy will fail. Let me say this again, I feel so strongly about it. All our efforts to strengthen the economy will fail unless we also take this year, not next year, not five years from now, but this year, bold steps to reform our health care system.” President Clinton in remarks to Congress (Wall Street Journal November 3, 1993, p1). We know health is unaffordable and we know the previous “business models” have not resolved the information management problems in health care so we need to begin to design systems that resolve the problems surrounding the direct patient care processes. That is the failure of the human mind to cope with the complexity of the modern health care systems. [Stead WW, Starmer JM. Beyond Expert-based Practice. Institute of Medicine (IOM) 2008. Evidence-Based Medicine and the Changing Nature of Health Care. 2007 Annual Meeting Summary. Washington, DC: The National Academies Press; 2008; 94–105.]
An example of the outcomes related to the problems of impaired clinical decision making can be seen in J. Wennberg’s “Tracking Medicine: A Researcher's Quest to Understand Health CareBy John E. Wennberg 2011.”
Proposed new models of care that can lead us forward have been clearly defined by Weed and Weed in their recent publication [Weed LL, Weed L. Medicine in Denial. Version 1.0 ed. Createspace. 2011. Available from
URL: https://www.createspace.com/en/community/ community/createspaceoverview?view=overview]
Now is the time to change the focus of out e-health expenditures and tasks and work together, business, clinical care, informaticians and patients. If not our unaffordable poor quality of care will persist. A/Prof. Terry Hannan