Saturday, September 04, 2004
More on IT in health care
I see that in Modern Healthcare’s annual search for the most powerful people in health care, first place went to Dr. David Brailer, the national healthcare IT coordinator in the U.S. Department of Health and Human Services (Modern Healthcare, August 23, 2004).
It reminded me that for our recent trip to Europe, I was able to make our airline reservations, print our e-ticket, pay for it, and print our departure boarding passes – all in the comfort of home by means of my trusty little PC. Furthermore, while in Europe I was able to make a cash withdrawal from my hometown bank in Harlan, Iowa using an ATM machine in Moscow, Russia. I was also able to read e-mail and send some messages from a small Internet Café on an obscure side street in St. Petersburg.
As far as I know, none of that was owing to the efforts of any national IT coordinator working as part of a Department of the U.S. Government.
So how does it happen that we have one in health care?
I suggest that it is because of deeply rooted weakness in the way health care is organized and managed. If any organization is to optimally exploit the potential of IT, somebody has to be in charge. Hospitals being institutions with nobody in charge, productive use of the technology is limited to activities (like accounting and human resources) that are peripheral to their core patient care functions. Furthermore, health care managers are not operationally oriented. Instead, they live or die professionally according to how well they manage the internal politics of the organizationally amorphous institutions in which they work. Tinkering with patient care operations only raises political issues, of which there are always too many already.
If the Department of Health and Human Services was willing to address this problem, it might do a lot more to promote the utilization of IT in health care than by appointing a national coordinator.
I see that in Modern Healthcare’s annual search for the most powerful people in health care, first place went to Dr. David Brailer, the national healthcare IT coordinator in the U.S. Department of Health and Human Services (Modern Healthcare, August 23, 2004).
It reminded me that for our recent trip to Europe, I was able to make our airline reservations, print our e-ticket, pay for it, and print our departure boarding passes – all in the comfort of home by means of my trusty little PC. Furthermore, while in Europe I was able to make a cash withdrawal from my hometown bank in Harlan, Iowa using an ATM machine in Moscow, Russia. I was also able to read e-mail and send some messages from a small Internet Café on an obscure side street in St. Petersburg.
As far as I know, none of that was owing to the efforts of any national IT coordinator working as part of a Department of the U.S. Government.
So how does it happen that we have one in health care?
I suggest that it is because of deeply rooted weakness in the way health care is organized and managed. If any organization is to optimally exploit the potential of IT, somebody has to be in charge. Hospitals being institutions with nobody in charge, productive use of the technology is limited to activities (like accounting and human resources) that are peripheral to their core patient care functions. Furthermore, health care managers are not operationally oriented. Instead, they live or die professionally according to how well they manage the internal politics of the organizationally amorphous institutions in which they work. Tinkering with patient care operations only raises political issues, of which there are always too many already.
If the Department of Health and Human Services was willing to address this problem, it might do a lot more to promote the utilization of IT in health care than by appointing a national coordinator.
