Word is out: CCHIT, an independent, voluntary organization with broad participation from health IT professionals, has announced their list of certified products (see HHS Secretary Touts Value of Certification on the AAFP site, which I found through an insightful post at MedPundit). I feel vindicated - not by the list of certified products, which holds no surprises, but by HHS Secretary Leavitt's explicit acknowledgement of the Prisoner's Dilemma problem I've been talking about (most recently in EMR: Threat, or Menace?, Digital Health Coming to Grandma's House, and EMR: How Likely?).
Geez, I hate being right...
Quoting from a speech by Mike Leavitt, they report:
In response to a question from the audience on the cost of certification to vendors, and ultimately to physicians and then consumers, HHS' Leavitt said, "The incremental increase in cost for a physician to have a certified system will be very small, but the incremental value it creates for patients and for medicine and health care in general cannot be measured."
Leavitt also acknowledged that the people who are expected to make the investment in EHRs -- physicians -- may not reap the financial benefit. "That dilemma is one we're having to deal with as a country," he said. "I feel confident that in time there will be ways in which society in general, and the government specifically, will find ways to help physicians adopt health IT."
So much for the facts. Now some psychic speculation.
After saying the above, Leavitt thought to himself, "Hmmm... Maybe a single-payer system would be a way to accomplish this goal, as it has in most of the rest of the advanced economies of the world..."
Then he stopped thinking.
As I said, the list (CCHIT Certified Products by Product) contains no surprises. It could be mistaken for a list of the most expensive EMR systems available. Vendors have to shell out twenty large (US $20,000) per attempt at certification, which is enough to keep the riffraff at bay.
Here's a ticket for a ride on the Clue Train for Secretary Leavitt, though I'm not so sure it stops anywhere in the Executive Branch any more. Physicians are rational, self-interested humans, the kind of consumer economists theorize about. Your value proposition will take money out of their pockets without providing anything of real value to them in return. For that matter, it hasn't actually been proven beyond a reasonable doubt that a certified EMR will benefit anyone, except of course the vendors, who should get back their twenty large on the first few deals, then start making money.
Q: What does an interoperable EMR represent to a practicing physician, first and foremost?
A: An easy way for others to steal their patients.
I may sound like I'm portraying these practitioners as a greedy bunch, perhaps, but no more so than anyone who is in business to make a profit, and a medical practice that doesn't won't be around for long. They have big loans to pay off, a family to feed, and these come first in the minds of the rational, self-interested Economic (hu)Man.
Then again, our healthcare system, and especially our healthcare policy, isn't particularly rational in the first place, is it? OK, I'm sorry I brought this up. Never mind...
I think that there are two views points to be considered when strongly advocating the use of EMR in practices. For a Doctor it needs to easy to use and save time so that more time can be spend on the patient. Currently we have many vendors with different types of EMR that are so hard to use that it simply puts them off. I think healthcare technology companies need to develop product after regular interaction with doctors to ensure that they provide just what is required. At binaryspectrum we have developed our healthcare solutions after spending countless number of hours with doctors to ensure that its work flow is kept simple and intuitive. This is then followed up with a period of Beta testing in real time environment before it is offered as a product in the market.
Posted by: Abdul Quddus | May 09, 2007 at 12:26 PM