The Big “O”
"O." No, not Oprah. Not Overstock.com. Not even the big "O."
"O" as in Obama. A short jaunt around the web HIT postings, blogs, and news items these days quickly provides an overview of the impact of "O" on the current state of healthcare IT. For an industry that appeared to have become somewhat stalled with abysmal reports on EHR adoption; standardization that seemed be slowing product innovation; and CHINs, RHIOs, and HIEs (with a few exceptions) failed or failing, the promises of the great and powerful "O" were like a shot of B12.
The incoming "O" has made lots of promises about advancing HIT, including megabucks and another of those "chicken in every pot" type remarks to provide an EHR for every American by 2014. (Believe that one?) Fifty billion dollar promises and a president who wants us all to electronify has been like the jolt of lightning awakening Dr. Frankenstein’s lifeless monster.
While it is encouraging that the new administration will have a much greater understanding and focus upon the importance of IT for healthcare, it seems O’s broad HIT promises have many abuzz that HIT is now poised to become an “overnight” success. (Like so many “overnight” success stories, it has admittedly been some quarter century we have been trying to achieve HIT stardom.)
Don’t get me wrong – I am all for the impact of the O-factor. The almost unbridled optimism that seems to have developed (even in some die-hard, conservative Republicans) for what the new administration may bring is quite contagious. The fact that O isn’t even in office yet and has already begun to steer the course of our country is quite impressive. The fact that so many initiatives seem to be under consideration is (and I don’t use the word cavalierly) awesome. Our country — cripes, the whole world — needs this optimism. We have some pretty major messes and we need some can-do folks at the helm.
What concerns me is the little “o”s, the folks who take what the big O says and immediately apply it to their personal agenda. Everyone sees the glory road to success as being whatever route leads past their own door. At the recent eHealth Initiative 5th Annual Conference in Washington, D.C., many vendors, politicos, and HIT proponents seemed quite enthralled that the 50 Big Ones promised by O over the next five years was the stimulus needed to finally push HIT past the tipping point. Of course, most of them also had a pretty specific idea about where that money needed to go to achieve the tip, usually somehow related to their current ambitions or agendas.
So, do I have my own agenda? Am I another little “o”? Of course. But, I’m trying to maintain a certain amount of historical perspective, too. The past 25 years have shown us that pushing HIT on both physicians and the general public is somewhat akin to pushing mules. You don’t get too far too fast. Merely telling a mule why they must move doesn’t work too well, either. Changing people’s expectations, processes, and workflow requires carrots, not whips, and turning those changes into habits is a derivative of time.
Hopefully, O and his people know this and just won’t throw those ever scarcer dollars to the little "o"s in hopes that what they’ve done before will somehow now work just because there’s money to burn. Yes, oh yes, we do need healthcare information integration and the technology it requires. But, what we really need are some disrupters to take advantage of this opportunity, to provide some innovative thought and leadership, and to figure how to turn “pushing mules” into riding race horses.
Dr. Gregg Alexander is a grunt-in-the-trenches physician and admitted geek. He runs an innovative, high-tech, rural pediatric practice in London, OH, and can be reached at firstname.lastname@example.org.