Kick legislatures out of health IT

I don't know about you, but I'm truly sick of hearing the words "health IT" and "legislation" in the same sentence.  Hey, federal and state lawmakers, it's sweet of you to care, but really, you shouldn't have. I mean, really.

While governments can certainly provide incentives to buy an EMR (tax credits), or to hook up to a health information sharing network (connectivity grants), or even to develop interoperability standards, micro-engineering health IT decisions just ain't gonna work.

Take the current measure steamrolling its way through Capitol Hill--a bill which, among other things, is intended to encourage healthcare data internetworking. Sounds good, but what are the odds that the Wired for Health Care Quality Act of 2007 [1] can convince health IT administrators to change their carefully-thought-out, facility-specific networking strategy?  

After all, even if you dangle big grant money, no IT smart exec is going to participate in an HIE network if he or she can't support it or their peers and clinicians aren't juiced about its prospects.  If I were an IT manager, I can't say I'd be too thrilled by the idea of supporting a RHIO/HIE, unless my facility had some specific to gain beyond some feel-good coverage by the local media and a drop in medical record requests by outside parties. (OK, I'm being too hard on HIEs, but you get my drift.)

My sense is that HIE and EMR-related measures are popular in legislatures because they're a way to look proactive in healthcare reform without having to upset powerful constituencies. It looks great -- "Hey, providers get quality improvements, vendors get bucks, everyone wins!"--but the truth is, it's just posturing. As far as I can see, is that the benefits of health information exchanges are still somewhat amorphous and the costs high.

So, all that being said, what should legislators be focusing on if they really want to lend a hand to the health IT sector?  Should they do more to foster standards development? Funding private research on the efficacy of specific health IT options?  Or should they should just step back for a bit and stay out of that which really can't fix? What do you think? - Anne [2]