HIMSS showcases bipartisan success and a market challenge

The biggest problem the industry faces is that, while government may all be on one side, doctors and many patients are on the other side.

Next week's HIMSS show in Atlanta will feature the most bipartisan aspect of health care reform, selling IT to hospitals and clinics so they can finally dump their paper records.

I know it's bipartisan because here's Newt Gingrich endorsing the effort, and a story praising that at Fox News. And here's HHS Secretary Kathleen Sibelius handing out $100 million to buy IT for pediatricians in 10 states.

This last is especially significant because the money isn't coming from that Democratic-sponsored Obama stimulus, which will eventually put $19.2 billion into health IT. Instead it's coming from the bipartsan Childrens Health Insurance Program (CHIP), which since it's run by states is known as S-CHIP.

All of which should make the big cookies at the Georgia World Congress Center taste even better than ever. While vendor efforts to maintain proprietary advantage through certification have failed, the CCHIT group itself is prospering. (Want to lead it? They're looking.)

The biggest problem the industry faces is that, while government may all be on one side, doctors and many patients are on the other side.

I personally see several doctors over the course of a year, and none have moved off paper. In my talks with them I find them terribly reluctant. They are waiting for someone -- maybe the hospital where they have privileges -- to both force them in and pay for it.

The reason for this is training. Doctors know how to use their paper forms. They know how to file them. They secure them by locking them in a room. In a small practice the cost of billing can be managed. Most Electronic Health Record (EHR) systems on the market require weeks of training, implementation and follow-up, and most internists' offices are like busy freeways.

I wrote a few weeks ago about a company called SharEHR, offering a cloud-based solution requiring no doctor retraining. But that company won't be at HIMSS, which has always been more focused on the needs of big hospitals than on small clinics. (The H in HIMSS stands for Healthcare, but it should really stand for hospital.)

HIMSS and the businesses serving it have for years been focused on the problems of billing, which in a scaled hospital setting with thousands of employees are considerable, but in a small practice with only hundreds of patients are manageable.

What has changed over the last year is the government's emphasis in health IT, moving from billing to data collection, from getting paid to using data in business transformation. Getting a result there will require cooperation from small practices, and I have yet to see it on the ground.

Patients, meanwhile, appear ambivalent. While most, like me, are tired of the hassle involved in completing new paper forms whenever they see a new doctor, and often repeating the process with doctors they know, many also fear how the new electronic records might be shared with people they don't know.

One can argue that health reform, at its heart, eliminates the incentive for insurers and employers to pry into those records, but that might be perceived as a partisan point.

Besides some of the features of electronic records, like e-prescribing, might end system abuse by patients that those patients don't want to see ended.

So while health IT may be a bipartisan success story, the sales job is only half-done. For both parties, and for the industry, getting the cooperation of doctors and patients is going to be a hard job.

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