EHRs: The cost of top-down decision making

by Healthcare IT News

I'm going to break a bit out of my area to talk briefly about electronic health records (EHR). But there's a parallel with ICD-10 implementation.

It's not a stretch. Many vendors are selling EHR systems as part of Meaningful Use and/or ICD-10 compliance.

But let's look at what's happening in Great Britain. Or not happening. Britain's National Health Service (NHS) has discontinued its EHR initiative. This is a massive project that the government ran and bid out to contractors. But it's not working.

U.S. healthcare experts are blaming the top-down decision making. And by the top, they mean the NHS. In the United States and Canada, governments dictate standards not tools.

Dr. David Blumenthal, former national coordinator for health information technology in the Obama administration for two years, explains why that's not the way to go.

“In a complex health system, you have an enormous number of independent actors, especially in a system like ours, but in England more than they thought. Physicians and health care professionals have to be part of the process every step of the way. You need to make this a collaborative effort, not a top-down procurement project.”

You can argue about how much independence healthcare professionals have in the United States. But you can paste Blumenthal's comment into any advice about ICD-10 project management. Or any major IT project.

Britain's non-exclusive effort cost billions. Scale that down to your practice or hospital. It's not billions but it's still too costly.

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Carl Natale blogs regularly at