HIPAA remains the EMR deterrent

I recommend it.

But I especially recommend the second part, where she has a pullquote from John Halamka (author of the blog Geekdoctor) answering the key question of why we don't already have this stuff:

The challenges are more on the policy side than the technology side...It's who gets to see what? When do you get to see it? What is the patient consent?

Most of these problems come out of the HIPAA law, but more of them come out of the need for that law. The law is necessary because insurers routinely use health records to raise prices or deny coverage altogether. Employers seeking to limit their own costs share this incentive to pry.

HIPAA was a band-aid around this gaping wound. Almost as soon as the law was passed an arms race began, fueled by lawyers and lobbyists, aimed at getting around the law. Many doctors opted-out of the war, taking advantage of a provision that allowed small practices to stick with paper.

Without HIPAA, and the need for HIPAA, there is no doubt more doctors would be paperless. We might have already gone through several generations of electronic systems, and ironed out many bugs that still exist.

Automation saves money and saves lives, in every industry where it is deployed. There is no reason for medicine to be 20 years behind the times, other than the political battle between privacy and market incentives.

There are two ways this can end. Either eliminate the market incentive to peek, which insurers are offering to do (so long as a "public option" doesn't exist) or give them the data they need to do business.

We have seent the third option and it doesn't work.