Some of you might know that I’ve harboured a small enthusiasm for aggressively using IT to drive down costs of health care, as well as improving quality, safety and providing data for researchers. In the future it may even be possible to couple these databases to expert systems that provide secondary diagnoses to help doctors do their work and keep an eye out for the bad apples.
In the USA US$20 billion dollars of Obama’s stimulus package has been allocated to encouraging practitioners and hospitals to introduce electronic medical record systems. Each recipient will source and install their own systems.
Much as it pains me to say it, this is a job that cries out for consolidation. Medical records work best when they are universal and portable. The approach taken in the US stimulus bill won’t achieve that. And even if it did aim at a central records service, the history of large IT projects is one of nearly universal failure.
One software package that might be a candidate for such a system is the USA Veteran Health Administration’s system VistA (not to be confused with Windows). The VHA has the lowest cost and the highest safety of any part of the US health system; the stable, mature, universal and user-friendly nature of the VistA system seems to have had a very large role in providing these outcomes. However it looks as though VistA will not even get a look-in as part of the US$20 billion allocated for healthcare IT reform.