We spent National Health IT Week peeking through the eyes of others at possible health IT futures.  So we'll start this week with the views of someone who points to a radically different future for health IT in large part by claiming that current health IT options are pretty miserable.

He starts by asking rather pointedly, "Why is health IT so bad that massive government and health system subsidies are required to drive adoption?"

He works his way toward his core answer by noting "While it may seem easy to bash legacy health IT vendors, my experience has been that vendors reflect their customers. I would take this a step further. In the case of healthcare, customers reflect the reimbursement model. It's a reimbursement model that is so broken Americans pay nearly twice as much as other countries to get inferior outcomes."

In short, the fee for services approach to healthcare has led many providers to focus their IT implementation efforts on new, more efficient ways to bill their patients.  Moreover, he argues that the recent introduction of patient portals, while presented as a way to get patients to manage their own health information more comprehensively, are little more than marketing projects.

All that said, he suggests that "tectonic shifts are underway" as "healthcare providers are getting far more aggressive about trying new models without doing the equivalent of organizing the Roman Legions."

He points to some interesting pioneers who are using IT to develop new care delivery and payment models.  But wandering through these and other options brings us back to what we'd call a modified version of his opening question:  "If health IT options are being developed that promise to change the landscape of healthcare delivery and organization, how are the massive government subsidies designed to move providers to one specific, if broadly defined, IT solution, helping the cause?"

The point is not to cast complete doubt on, in particular, HITECH.  Rather, it's to wonder whether the single-minded focus on EHRs will accomplish all that policymakers hope for, or whether HITECH will prove to be a well-intended attempt to impact a landscape that was bound to change on its own, and that ultimately changed too quickly for policymakers to keep abreast of.

Your thoughts?