By Evan Falchuk
New IT systems are impressive and give the appearance you are operating in a state-of-the-art environment. But do they really do any good if all they are doing is “computerizing the current set-up”? It’s pretty much what we’re doing in the government’s massive new health care IT program.
It’s the typical problem in failed IT implementations. A business decides that some new IT system will fix its cost or quality problems, but once they’ve implemented it nothing is really changed. Only then does it become clear that the real problem was a broken work-flow, or a staff problem, or something else. Organizationally it can be hard to confront these problems, so it’s not surprising that many businesses choose to go the easy route of just trying a new IT system first. It’s a sort of magical thinking — and there are thousands of IT consultants who are happy to help businesses spend their money in this way.
Is this happening in the push for health care IT? It sure seems like it. The latest proposals for Regional Extension Centers call for tens of millions of dollars to be spent on localized teams of implementation experts, tasked with helping physicians practices across the country spend billions of dollars to implement electronic health records. And the government is serious about it: if doctors don’t get the new IT systems in place, they will suffer financial penalties.
But is anyone asking about how the work flow of physician practices operate, and how they ought to operate? Or how an EMR will affect doctor-patient relationships? Or even exactly what we want these new systems to actually do, other than computerize what is currently not computerized?
The concern I often hear from doctors is that no one is listening to them in the headlong rush to implement new IT systems. It’s an old story, and sounds a lot like the things you hear in the early stages of misdirected IT implementations. But it doesn’t have to be this way. Groups like the Massachusetts eHealth Collaborative have been busy for years doing the very hard work involved in figuring out the way care is delivered, and then helping to implement solutions to support better work flows.
Hopefully, these Regional Extension Centers can become something more like this – a quality improvement engine that helps physicians understand and improve their work flows, and then implement IT. If not, we run the risk of living out the satire Monty Python foresaw decades ago.
