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Did policymakers choose the wrong path?

How’s that country song go?  “Looking for love in all the wrong places”?

If you don’t mind us channeling our inner Waylon Jennings, that’s what came to mind when we read an article about one health IT observer, who has argued that “Healthcare quality and efficiency could move forward 20 years in a matter of months if only there were true interoperability of electronic health information.”

A matter of months, eh?  It’s an interesting proposition, and while we’re in no position to make such a bold claim, we’ll admit that we have wondered fairly frequently if policymakers didn’t charge off a bit prematurely with the HITECH incentive program.

After all, it’s no secret that interoperability, or the lack thereof, remains a real problem when it comes to the spread of EHRs.  So why not solve that problem first and then push providers across the digital frontier?

During last week’s American Medical Informatics Association (AMIA) annual conference in Chicago, the observer, sociologist Ross Koppel of the University of Pennsylvania, argued that “While the goals of Meaningful Use — to improve the safety and efficiency of healthcare delivery — may be noble,  . . .policymakers have been too focused on EHR features and not enough on usability.”

Had policymakers paid more attention to usability, Koppel said, including interoperability and data standards, they may “have seen how health IT has been burdened by too many standards and not enough cooperation among competing technology vendors and healthcare providers.”

For example, Koppel “said that there are about 40 different ways to record blood pressure in EHRs. At least from an informatics standpoint, perhaps three of those ways are ‘proper.’”

So what of it?  It’s an academic question, no doubt, given how far down the road we’ve gone with HITECH.  But it seems worth asking whether we should have solved interoperability first, then promoted the implementation of EHRs. 

At the very least, by looking backwards at what perhaps should have been done, we might be able to hone in on what should be done now.