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Wednesday, December 30, 2009

The Risks of Health Information Technology

Dear Reader,

Health IT success or failure numbers are very hard to come by, in part because some healthcare IT vendors require their customers to sign contracts banning them from publicly discussing the success or failure of their health IT, in part because the legal stakes are much, much higher with health IT failures which creates a disincentive to be forthcoming about dramatic failures.

Most numbers therefore are anecdotal. For example, the American College of Physician Executives (ACPE) surveyed its thousand members in its 2004 Technology Survey, and the results suggested that even successful health IT projects are often more expensive and less useful than expected, often permanently reducing physician productivity.

Informal surveys of non-management medical professionals at hospitals adopting IT reveal a much lower rate of satisfaction than that reported by those in management positions. The most frequent complaints are (1) a poor fit between the software’s design and the needs of its users, (2) poor responsiveness to requests to improve the software, and (3) hidden and horrendous costs that emerge in IT adoption during the process of trying to get badly fitting software changed to truly meet the needs of its users.

Off the record health IT programmers are often surprisingly candid about how bad their software is and about how resistant health IT company management is to making unprofitable changes that would improve its quality. Producing bad health IT software has been very profitable for a long time.

Health IT is the industry that results when one industry in crisis attempts to assist another industry in crisis, creating a collision of crises. The emergence of an American health IT movement is an important step toward improving health in this country, but unless the true state of health IT is understood and dealt with it will almost certainly be a very painful step indeed.

Yours truly,

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