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Saturday, October 31, 2009

Meaningless Use?

The American Recovery and Reinvestment Act of 2009, better known as the economic stimulus package, includes a whopping $19 billion to support the development of electronic (i.e., computerized) health records to be used by hospitals and doctors.

In order to be eligible for grants, applicants must demonstrate that the application they wish to develop will have a “meaningful use.” Much negotiation is going on between the industry and the government as to how “meaningful use” will be defined. For example, what percentage of drug orders has to be computerized by what date.

This whole story is a commentary on how the management of health care is perceived. The insistence on “meaningful use” reflects a suspicion that health care providers, particularly hospitals, are more interested in the appearance of achievement than in its actual realization – a concern that hospitals would proudly announce success in receiving a big government grant and then spend it on computer hardware and software without actually doing anything that improved the quality or reduced the cost of care.

It also raises the question of why health care providers should need a major infusion of government money to take advantage of information technology. Banks didn’t need it to get rid of checks and airlines didn’t need it to get rid of travel agencies. The money they saved by reducing cost was more than enough to justify the cost of computerization. Why shouldn’t the same be true of health care?

The answer is that the providers of health care have yet to become serious about reducing cost and the public has yet to ask them to.

In other words, we have yet to get serious about reforming health care.

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