I don’t wake up each day planning to be at odds with ninety-eight percent—I’m probably being overly generous assuming two percent of the people are as jaded as me—of the HIT community, maybe I just come by it naturally.
The first time I heard of RECs (regional extension centers) the first thing that came to mind was playgrounds, something akin to what the Police Athletic League might find useful. Five hundred and ninety-eight million dollars. They tried 597 and determined it wouldn’t be enough and figured 599 would be too much, but 598 million was just right. Then Goldilocks made her way over to the porridge—sorry for turning left at the fairy tale ramp.
A large part of the success or failure of reform hinges on the success or failure of EHR. Accordingly, the government made the egregious decision to manage the process of building and rolling out a national EHR down at the molecular level. They have involved themselves at the front-end, at the vendor level, and at the back-end. The more anxious they become, the more money they waste, adding another guise to get the healthcare providers to take their eyes off the ball. Five hundred ninety-eight million “we’re just here to help you” dollars.
This money could be spent to pay the top EHR vendors to create one set of standards and modify their systems to fit those standards.
Meaningful Use. Don’t get me started. How can I fault thee; let me count the ways. Those tested early for Meaningful Use will be examined less rigorously than those tested later. This is like the IRS saying that if you file your taxes in February, don’t worry about those silly little math errors. Healthcare will be the only industry whose software quality assurance check occurs after they pass the fail-safe point, the point of no return.
With good leadership providers should know EHR will pass meaningful use before implementing the system. If they fail to pass Meaningful Use, shame on them.
Pale Rhino Consulting 
A string of somewhat unrelated like complaints:
1) But everyone wants to make their own mobile app that solves something, loosing sight of integration.
2) What is “meaningful use” anyway? Isn’t that just a boldface term that amounts to going to conferences to talk about things that ought to simply be being done instead of all the discussion?
3) Why does healthcare consistently fail to hire the right people for the IT jobs? Promoting the cook to the director of IT may be great for encouraging “the family” of the organization, but isn’t effective.
4) Why does healthcare, particularly smaller organizations, always look for the piecemeal approach to IT solutions that goes directly in the face of integration. Lay out the dough and do it right.
5) Is it impossible to get the programmer, IT deployment folks and finance department folks in the same room at the same time and make a good decision? Perhaps after a year of uncoordinated meetings with subsets of the group it might look like a lot was happening without any results. Looks good for meeting security for next year!
These comments and many more are courtesy of someone frustrated with healthcare to the point of coming to the inspired observation that other industries actually focus on performance and getting things done rather than talking about it and understand investment in infrastructure. To the point of bailing healthcare. Time for healthcare to get it together.
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