At the National Journal Online, health policy analyst Uwe Reinhardt explains why the United States is lagging behind other industrialized nations in the adoption of health information technology (like electronic medical records or electronic prescriptions):
One explanation is that our health system has not been spending enough on HIT overall. It often is the stepchild in the budgeting process of hospitals and medical practices….A second reason for our lagging in HIT is that, by the very nature of our pluralistic health system and the equally pluralistic HIT industry, we have produced a veritable HIT Tower of Babel….A third reason for our lagging in HIT is that there have been too many fly-by-night outfits in this industry, often elaving their clients in the lurch over the longer run. HIT applications must be serviced reliably, over the long haul. Many users have been sorely disappointed in that area in the past.
But underlying all the questions about health IT is the question of who should pay for it. That is, while insurance companies could benefit from reduced costs in moving from a paper-based system to electronic health records, the costs of implementation are far higher for providers.
An analysis by the Center for Information Technology Leadership (CITL), for instance, found that “while providers are footing the bill for HIT, they may experience only 11 percent of the potential gain. Other stakeholders, payers principally among them, may reap 89 percent of the gain.”
Also, as Dana Blankenhorn of ZDNet speculates, “there’s another, deeper problem. Fear”:
Many doctors fear automation because documentation invites lawyers. As one correspondent put it: The Democrats love it because it will make it much easier to sue physicians. Auditing care will find mistakes, and mistakes will lead to lawsuits. Mistakes are inevitable, however, so don’t put anything down and maybe no one will be able to find out.
Still, according to a new Commonwealth Fund opinion survey of health care leaders, 78 percent of respondents thought that investment in health information technology was a very important or “absolutely essential element of a stimulus package.” In other words, the benefits of health IT — in terms of eliminating health errors, creating jobs and containing health costs — far outweigh its perceived dangers. The fear that doctors face in terms of increased litigation costs can certainly be addressed by designing a system that dismisses unmeritted or flimsy lawsuits, while at the same time punishing doctors for real medical errors. Smart policy can make that distinction, no?