Response to NY Times’ Steve Lohr — Healthcare Connectivity

horse-before-cartMr. Lohr, great article and thank you for covering this topic.

Any story about hospitals taking steps towards connectivity is great, but I fear that most think that connectivity is a little easier than it really is, that it’s just a matter of getting everyone together. Integrating hospital systems is challenging enough, but it’s “everyone else” that will pose the greatest challenges and thus making connectivity a fragile vision if it cannot be streamlined for smaller practices, independent physicians, clinical labs, etc.

Mr. Lohr points out that only 25% of physician practices today are computerized, and that should improve given incentive payments and consequences for non-compliance. However, the real issue is that we are putting the carriage before the horse; physicians will adopt patient management systems, EHRs, and EMRs, but the connectivity piece will still be unanswered. Furthermore, smaller practices and physician groups most likely will not understand why it is that further steps for compliance need to be taken as most of them are being educated (by the very software vendors selling them their wares) that if they merely install software that allows them to manage patient data digitally, they are going to get compensated.

Recently on a call with a hospital CIO, we discussed how they had to put a connectivity project on hold because of the 200 physician practices outside of her hospital she had to bring onto the network, only 120 had EMRs and none of them wanted to deal with having to deploy and manage a VPN. Seems trivial, but the reality is that doctors are doctors 1st and anything not related to treating patients is a distraction and is perceived to decrease their bottom line (In the Docs’ defense, VPNs are a blunt instrument and I don’t blame them).

Healthcare connectivity is a long, windy road that needs better planning, better ideas, and better solutions. The Direct Project sponsored by NHIN is a great foundation for simplifying and standardizing connectivity, but this battle also needs to be won with hearts and minds.



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