In short, the most rigorous studies to date contradict the widely broadcast claims that the national investment in health IT—some $1 trillion will be spent, by our estimate—will pay off in reducing medical costs. Those studies that do claim savings rarely include the full cost of installation, training and maintenance—a large chunk of that trillion dollars—for the nation's nearly 6,000 hospitals and more than 600,000 physicians.
But by the time these health-care providers find out that the promised cost savings are an illusion, it will be too late. Having spent hundreds of millions on the technology, they won't be able to afford to throw it out like a defective toaster. Link to WSJ article
Health information technology is held up as the means to improve health outcomes and reduced cost of care - we will be able to eliminate redundant tests, share information seamlessly from doctor's office to emergency room to hospital, and we will be able to order just the right tests and stop all this waste and inefficiency.
This message sells very well in Washington DC but fails to resonate with many in the front lines of health care. Software developers and vendors want market share and have made their systems largely incompatible with others. Success in this seamless environment appears possible only if one chooses a monopolistic vendor that locks you up in ancient legacy code requiring substantial and expensive work-arounds to achieve desired ends.
Sadly, this myth is translated into major national initiatives helping primary care step up to its role as the foundation of high performing health care. Primary care has been systematically under-funded relative to its benefit to people and population outcomes. Starved for resources to help their patients, struggling primary care providers grasp at "meaningful use" and "PCMH" dollars contingent on buying into the boondoggle.
The boondoggle is compounded by the idea that health information technology will somehow produce meaningful patient data for quality measurement and improvement - another point where they hype is far far ahead of the reality. Producing meaningful quality data from electronic health records is proving a major headache and cost, eating up scarce resources that might have been applied to patient care.
Digitized records have great promise but the current crop woefully under-performs on key functions: true interoperability and ease of use in real patient care. If our nation wants to improve population outcomes and the experience of care and hopes those improvements lead to reduce cost trends, then we ought to shift our focus to those things we know drive the outcomes: give more people access to good primary care, support primary care as a career choice, make it easier for primary care clinicians to do the best job they can for their patients, and stop mandating tangential and ill informed mechanisms.