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Managing expectations: the toughest part of health IT
With any effort as all-encompassing as moving the healthcare sector to EHRs and other health IT, it’s inevitable that a significant amount of time and energy is going to be chewed up by the question “How are we doing?”
In our view, answering that question is going to be made infinitely difficult by the fact that, well, there really isn’t going to be one simple answer.
That thought came to mind as we read this longtime observer’s reflection on “the difference between the potential and the reality of health IT.”
He’s thinking specifically of how policymakers should proceed as they begin gearing up for Meaningful Use Stage 3, and he recognizes that, to a considerable extent, policymakers are stuck between a rock and a hard place.
“If they ask for too much,” he says of the policymakers responsible for the next round of regulations, “many providers will be unable to keep up, and there will be pushback. If they ask for too little, many providers will be content to do the minimum required for incentives without using technology's full potential to improve quality of care.”
He notes, for example, that even now “physicians and hospitals are making uneven progress toward the long-term goal of a fully digital, connected healthcare world,” with physicians making variable use of their EHRs even after they’ve attested to Meaningful Use.
In our view, though, this is inevitable, and somehow policymakers and health IT advocates are going to have to make their peace with it. After all, healthcare may be looked upon as an “industry”, but the “product” it peddles – Is it good health? Effective treatment? Preventive measures? All of the above and more? – ultimately defies, to put it mildly, the parsing, categorization and technologically-aided efficient management of just about any other industry you can name.
We’re talking about human beings, after all, on both the doctor and the patient side of the “inputs and outputs” equation. And for an infinite variety of reasons, human beings do not always do what they “should” do. Consequently, it seems a very safe bet that the universal, optimal use of health IT will never be achieved.
That said, health IT stakeholders of all types would not be doing their job if they didn’t keep trying to achieve the highest and best use of the available technological tools.
So how, then, can policymakers try to have it both ways and continue pushing providers toward goals that they know will never be reached? Well, if we can piggyback off what we said at the top, there’s no simple answer to that question. Perhaps part of the answer, though, lies in recognizing that despite the great strides taken in just a few short years, the long road ahead will consist of much smaller, steadier steps, with no clear end in sight.
And on a more immediate level, we couldn’t agree more with our colleague, who notes “this is an enormous industry with a lot of regional, cultural and technological variations, and no one should think that a federal ukase is going to create the connected world within a few years. The Health IT Policy Committee would be wise to look carefully at what's happening (in) the field before it commits itself to a radical course in Meaningful Use Stage 3.”
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