Decisions in health care (Electronic Medical Records): It’s the money stupid!

Health affairs blog notes that the decision to implement and fund the electronic medical record was based on faulty research that indicated it would save money.   The premise was wrong.  And the the flaw in the research, in part, was that the research and the decision to fund was influenced by lobbyists paid by vendors of such systems—greasing the wheels so to speak.  This is highly legal, given the Supreme Court’s granting of citizenship to corporations and moneyed interests, allowing them unlimited “access” (ability to bribe)   to whichever political hack who would support their plans.

Long before Congress created the Health Information Technology for Economic and Clinical Health (HITECH) Act, giving $32 billion to health care providers to transfer to Electronic Health Records (EHR) vendors, plans for that windfall were created by an by Health Information Technology (HIT) vendors, HIT enthusiasts, and friendly politicians (like Newt Gingrich).

The plans included an enormous lobbying campaign. Congress responded obediently. Most commentators focus on that $32 billion for the HITECH Act’s incentives and subsidies. But that was only seed money. The real dollars are the trillions providers spent and will spend on the technology and the implementation process.

Much of the economic justification for the spending on HIT was based on a now-debunked RAND study that promised up to a $100 billion in annual savings. Recently, however, in a remarkable act of ethics and honesty, RAND disclosed its previous study’s problems, dubious data, and weak research design, and that the research was subsidized by two of the larger HIT vendors (Cerner and GE).

Interestingly, in contrast, the Congressional Budget Office (CBO) and the Office of the National Coordinator for Health Information Technology (ONC), both of which touted the first RAND study, have not issued reassessments of their happy predictions but continue to promote HIT’s cost savings and improved patient safety. While HIT should be and absolutely is far better than paper records, more than 30,000 studies had already failed to support such bold assertions of powerful improvements in health and efficiency. Moreover, the research designs of all but a tiny proportion of those studies were too weak to yield trustworthy conclusions. And the best of them showed few if any benefits. This comes to the heart of our concern here: the use of weak research in support of less-than-effective health policies and medical treatments.

Medicynical Note:  And yes, there is no shortage of political hacks in our congress.

Skim milk masquerading as cream, again.  Is this any way to run a government? 

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One response to “Decisions in health care (Electronic Medical Records): It’s the money stupid!

  1. One of your blogs elicited a good question from a reader: What can we do about this mess? (The question could be applied to most of what you report – all the mess.) You seemed to say that there’s no good or easy answer. I would add, not in our lifetime, or at least until the revolution.

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