

Your address to HIMSS acknowledges many of the problems with Healthcare IT, highlighting lack of interoperability, lack of data exchange, and lack of cybersecurity, and suggesting some regulations that could be eliminated. This is a welcome realization of some of EHR’s more obvious limitations and problems. However, most of your recommendations for improvement of health IT are insufficient, unproven, or have been repeatedly shown to fail.
We applaud your acknowledgement of: 1. The frustration (and often rage) of many clinicians when using the current EHRs’ clunky and inefficient user interfaces; 2. Patients’ frustration and alienation when doctors spend much time entering data into the EHRs rather than listening to them; 3. The need for better cybersecurity; 4. Benefits of increased patient access to their data; and 5.Healthcare systems’ refusal to share patient data with others clinicians (data hoarding).
We are also delighted for your strong support for the Sync for Science program.
However, your solutions to these problems are faulty or have already failed—and thus we are obliged to explain why and how they fail:
- Belief in the magic of value-based care as a cure for excessive spending
- Claim that “open APIs” (defined in next sentence) will solve the problems of lack of interoperability. Here, APIs refer to software programs that try to translate different forms and formats of information into a single commonly understood item.
- Belief that a patient’s personal data store or personal EHR, called “MyHealthEData,” will help solve the problems of patient care.
- Confusing patients with customers. We train doctors to make diagnoses, order and interpret tests, and help patients make profoundly complex decisions. Healthcare decisions are not like buying a toaster.
- Attributing so many of the problems of EHRs to the regulations created in 2009, the “Meaningful Use” rules. In fact, meta-analyses of EHRs—both before the Meaningful Use rules, and after–fail to find they reduce costs, mortality, or morbidity.