The government, like EHRs, needs to be reliable

We expect our hospitals to be dependable. They'll be open during a blizzard. They'll have backup generators when the electricity goes out. Unless there's an overwhelming disaster, like Hurricane Sandy or a tornado, we can count on them to do their jobs. They are reliable.

Electronic health records are, for the most part, reliable. But one of the downsides to EHRs is that when they don't work, the hospital is at a standstill. We've seen this before, with EHR glitches forcing Sutter facilities and Boulder Community Hospital to their knees. It isn't pretty.  

It's one thing when a hospital has to shut down or curtail operations because of an event beyond its control; we may not like it, but we understand and tolerate it. It's another thing entirely and totally inexcusable when a shutdown is caused by poor judgment, user error, and in essence was totally avoidable.

And that's how our government has shut down.  

We expect our government to be reliable and perform its day-to-day functions. Having the government shut down because of a natural disaster is understandable. Crippling government operations because members of Congress can't play ball together is ridiculous.

Now, so many of aspects of healthcare and health IT are on hold: work on improving health information exchange interoperability, creating standards, finalizing rules, public health--it's all at a standstill.

Ironically, the shutdown failed to stop the two healthcare initiatives the GOP most opposes: the Affordable Care Act and the Meaningful Use Incentive Program. Talk about cutting off your nose to spite your face.

Now the House of Representatives wants to reopen select programs, such as the National Institutes of Health and the national parks. The Senate has rejected this piecemeal approach, as have the American Public Health Association and other public interest groups, calling it "cherry-picking."

That makes sense. If you can't come together to fund all of the government, how do you decide which initiatives deserve to be re-funded first? What functionalities of your EHR do you restore first, and which can wait? Do you sacrifice electronic prescribing for resumption of clinical decision support alerts? Which is more essential?

And who should make such a determination? The hospital board of directors, which doesn't use the EHR on a day-by-day basis?

So why should the House of Representatives pick and choose which parts of the government should go back on line? Why NIH, and not the CDC?   

If a hospital board of directors acted as irresponsibly as the government is acting, I'd bet that the board would be replaced in short order.   

We should be able to rely on the government to stay open. We should be able to rely on congress to do its job. We need the government to be dependable and trustworthy. People don't want this shutdown.

Plenty of people are wary of EHRs. But EHR systems are still more reliable than the current government. - Marla (@MarlaHirsch)