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NEJM offers far-ranging takes on HIT implementation

As the summertime vacation season rolls around, people always need some light beach reading, right? The New England Journal of Medicine offered three articles in its June 14th issue that might not quite measure up to an Elmore Leonard crime thriller or drippy teen vampire romance in terms of entertainment, but they will definitely get leaders involved in HIT implementations taking stock of the direction they’re going.

First, Spencer Jones and his colleagues tackle the “IT Paradox,” or the fact that employee productivity generally goes down for a period of years after an industry such as banking takes on new technology upgrades. That’s because, they authors say, whenever an industry – going back to 19th century mills replacing water wheels with electric motors up to and including the 1980s, when IRS field agents were given new mobile computers to streamline the audit process…which included inserting up to 18 diskettes in the process of auditing – there’s a long adjustment arc between when a technology is introduced to the point where it’s actually used well.

There’s a lesson in there for health IT. Improving productivity with technology involves getting people doing health care, not just programmers involved in the development process: “New health IT systems risk failure if usability isn’t carefully addressed. User-centered design calls for and users to be involved in every stage of product development,” the authors write.

In “The Health Care Jobs Fallacy,” Katherine Baicker and Amitabh Chandra suggest that the burgeoning job market in health care isn’t necessarily as good of a thing for the economy as it might seem – especially in light of federal cost-cutting health reforms under way: “… if the same outcomes can be achieved with lower employment and fewer resources, that leaves extra money to devote to other important public and private priorities such as education, infrastructure, food, shelter, and retirement savings,” they write.

Lastly, old friends of SearchHealthIT who both are M.D.s and open-source advocates Kenneth Mandl and Isaac Kohane write of “Escaping the EHR Trap.” They call out EHR vendors for propagating “the myth that health IT is qualitatively different from industrial and consumer products in order to protect their prices and market share and block new entrants,” and instead call for “cheaper, and nimbler tools for managing health care’s complex tasks.” Interesting stuff that big EHR vendors are not going to want to hear.

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Tackling the IT Productivity Paradox for #HIT. Better than a vampire romance?
IT Pulse: @DonFluckinger explains how @NEJM looks to future of #HIT implementation: #HCSM #HealthIT #HITsm #EHR