The details are indeed devilish

As the old expression goes, the devil is in the details. Scanning the news this week, it's become abundantly clear that those delving into the finer points of the health IT portion of the American Recovery and Reinvestment Act are acknowledging this fact.

To nobody's surprise, in a recent webcast, national health IT coordinator Dr. David Blumenthal discussed many of the challenges in EMR implementation while, naturally, trying to sell the healthcare community on the benefits of EMRs. Culture change, of course is tough. So much so that a new list of 10 recommended "basic patient safety reforms" from advocacy group Public Citizen contains nary a mention of EMRs or health IT. Sure, it's possible to institute a culture of safety without IT, but good luck maintaining such a program over time in the paper world. And good luck earning any pay-for-performance bonuses without an EMR in a truly reformed healthcare system. (Whether or not we achieve real reform is another story, but we'll eventually get to a system that pays for quality rather than quantity.)

If you've got, say, an hour to kill, try to digest this lengthy piece from the New York Law Journal about the myriad legal issues surrounding EMRs, the stimulus law, HIPAA and state efforts to promote IT. If you're reading FierceEMR, more than likely you're already aware of most of these challenges. As the exuberance of passage of the federal EMR incentive program wears off and the industry gets back to work, the rest of the world is discovering just how devilish the details can be.

Good luck. - Neil