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How to Waste a Boatload of ARRA Money

Cindy on BusI want to take a moment to make sure we are all on the same page here with the business of health care  reform.  This is inanely simple.  When it comes to health care, keep doing things the same way.  It’s a proven business model. Here are a few specific pointers.1) Don’t Involve ConsumersThis is really critical.  Do *not* ask consumers what they want.  Whatever you do, don’t ask consumers to define “meaningful use.”  These kinds of rhetorical debates are best left to academics and bureaucrats inside the beltway. Every time a consumer mentions anything resembling meaningful use or a “personal” health record, change the subject immediately.2) Act Like Privacy Issues are InsurmountableThe possibilities here are endless.  The more you can distract consumers with potential privacy issues, the less they will pay attention to the ways in which they would benefit from having true ownership of their health care data.

3) Don’t Learn from Other IndustriesDon’t bother reading that book by Clay Christenson.  He has spent a decade studying the inefficiencies of the health care system.  Inefficient by whose standards?  Let the academics put their two cents in when it comes to meaningful use, but don’t listen to any of that Harvard B-school innovation nonsense.4) Act Like Open Source Doesn’t ExistFortunately, most people have long forgotten that once upon a time, software was free and/or inexpensive.  They continue to blindly support proprietary software, even during a prolonged recession.  They even purchase new computers to run this bulky, expensive software!This ties into the next point. 5) Think Short TermThe time to think through any major conceptual problems is not now.  Come up with brilliant, yet strangely expensive health care solutions (remember, they must be proprietary).  Don’t worry about long term sustainability or stupid things like sharing your source code.  Having proprietary solutions is exactly the leverage you need to maintain your involvement in perpetuating, I mean solving, the problem.  This is advice you can (both literally and figuratively) take to the bank.Oh, yeah, speaking of the bank, by the time tax payers realize what you’ve done, you will have already deposited your bonus check and had a fabulous spa treatment.

Cindy Throop is a University of Michigan-trained social science researcher specializing in social policy and evaluation.  She is one of the few social workers who can program in SAS, SPSS, SQL, VBA, and Perl.  She provides research, data, and project management expertise to projects on various topics, including social welfare, education, and health. www.cindythroop.com

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Kishore SomanathanDeepakJohn SchenePKTom Leith Recent comment authors
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Kishore Somanathan
Guest

Cindy,
Some very good points. Good points on the maturity of open source software as well. We are no longer talking about Apache 10 years ago. If not purely open source, there are defnitely cheaper solutions being built that are easily integateable with other technologies.
Again, good points on getting customers involved from the get go.

Deepak
Guest

Buying EMR or EHR directly for the software manufacturers is frought with fault. You need an IT partner on your side. We at Informed Inc. are here to help. With our healthcare and IT specialists, we can help you navigate the EMR landscape to identify the right solution at the right price for you.
We know how important is your practice for you and we ensure we keep that trust through the entire implementation process.
We are your EMR implementation partner. Please visit us at http://www.informed-inc.net

John Schene
Guest
John Schene

Sorry to say this, but if you don’t work for a member organization or are an individual/student member of the HL7 organization then you don’t have free access to the current versions of HL7.
John

PK
Guest
PK

Interoperability will only be achieved when we have the network and the yellow pages to go with it available to all. How can Hospital A connect with Hospital B or C or D in a cost effective manner without knowing the connection? BUILD IT LIKE THE BANKS – it’s been way to long (CHIN, RHIO, HIE….yada yada yada)

Tom Leith
Guest
Tom Leith

The “HL7 is Free or UnFree” debate is amusing. Yes, it is free, there are no license fees. No it is not free, it costs $600/year to have the latest specification. I was very fortunate a few years ago, while preparing to teach a course on information technology in healthcare, to have lunch and a little “interview” with Samuel Schutz, one of the inventors of HL7. He was for awhile at the University of Missori’s Informatics program, and is now with Cardinal Consulting. (http://ccigroup.org/index_files/Page354.htm) He told me the group’s original intent was for HL7 to be run in the style… Read more »

Wendell Murray
Guest

“I’m convinced that an inexpensive EMR could be built on a Linux-Apache-MySQL-PHP platform (a LAMP stack) using a combination of an existing CMS with an ecomm solution like Ubercart.” Already exists as openEMR. PatientOS is Java-based and has significant potential in my opinion. “‘Open source’ is another term that gets bantered about endlessly and seems to somehow manage to stay free of any type of negative association.” It is free of negative associations because there are no negative associations! I read recently an excellent article by a developer who developed a commercial application that competes with several open-source projects that… Read more »

bev M.D.
Guest
bev M.D.

Well, here’s one big vendor’s take on ARRA money(hint; the title is, ARRA could boost Cerner take 33%):
http://kansascity.bizjournals.com/kansascity/stories/2009/04/27/daily29.html?surround=lfn
Talk about brazen salivation in public….is that legal?!

Doctor Seven Levels
Guest

How objective are the commentators of this post?
I have my doubts!
Dr. Seven Levels

The HL7 Guy
Guest

With all the evidence discovered that most of the commentators of this post have strong ties to the author, I rest my case.
Where is the objectivity of this post?
Please reply!
The HL7 Guy

The HL7 Guy
Guest

With all the evidence found, I rest my case. Where is the objectivity of this post?
The HL7 Guy

MD as HELL
Guest
MD as HELL

Have at it, folks. Too technical for me and most patients. Don’t forget that most patients are healthy and are never going to care. Most doctors view the computer as a resource but not a patient care tool.

Cindy Throop
Guest

Huh?
Just kidding.
I think the information above is more than enough to write a book or two on HIT for Dummies, HIT for Wonks, etc.
I look forward to learning more.

Merle Bushkin
Guest

Cindy, the discussion you launched would be amusing were the issues and subject matter not so serious. The variety of perspectives represented is a perfect metaphor for what ails healthcare and healthcare IT. We start out with a simple question and the discussion rapidly degenerates into tech-speak that obfuscates the issues, eg., open source vs proprietary software, harmonize vs. what — fight? interoperability vs EMR systems that can’t/won’t share data, government control vs capitalism, bank silos vs care provider silos, etc., etc., etc. It’s like the old story of the blind men and the elephant! I share your appreciation of… Read more »

Robin Shorrock
Guest

hi all, i’m coming to this late, but is great debate. Maybe I can add something, maybe not, but let’s see. i’ve just spent 3 years working on the UK NHS national EHR. It has been hard and very difficult. Is it a success? At the moment, not really, but at least a basic level of functionality has been put in place and there is potential for it to grow. This assumes that the significant non-technical challenges can be overcome. I won’t repeat these because they chime with everything said above. In terms of standards, the UK NHS EHR builds… Read more »

Randall Oates, M.D.
Guest

Today, the average cost for a simple HL7 interface using v2.x is $14,000 to small practices. This has proven to be the key obstacle to the interoperability that is already possible. Can anyone offer any evidence this obstacle of affordability is not about to become far worse if we continue to follow the road maps proposed by those currently controlling the industry? Perhaps PHR interfaces will finally bypass the silos and bring affordable interoperability to the masses?