It's time for statesmanship to prevail in EMR policy


It's widely known that in his farewell address to the nation nearly a half-century ago, President Dwight Eisenhower cautioned against the outsize influence of the "military-industrial complex." Often forgotten is that Eisenhower also noted an "equal and opposite danger that public policy could itself become the captive of a scientific-technological elite."

That's where we find ourselves right now in terms of the federal stimulus for EMRs.

Today's issue of FierceEMR references an article written by HealthSystemCIO.com founder and publisher Anthony Guerra, in which Guerra calls the stimulus "irresponsible." My reading of Guerra's article suggests the American Recovery and Reinvestment Act may have skewed toward the scientific-technological elite side of Eisenhower's schematic.

I'd also like to call your attention to the news that Northrop Grumman has won a $34 million federal contract to develop a database for CMS to track bonus payments for meaningful users of EMRs.

If that name sounds familiar, it should. Reston, Va.-based Northrop reportedly is the third-largest contractor to the U.S. military, after Lockheed Martin and Boeing. Like many of its competitors, including Lockheed, Northrop has developed strong health IT consulting and contracting businesses in recent years. Others making the leap from the Pentagon to HHS include Harris Corp., Computer Sciences Corp., BAE Systems and Dell Perot Systems.

In other words, the military-industrial complex has become the medical-industrial complex.

"We must never let the weight of this combination endanger our liberties or democratic processes. We should take nothing for granted. Only an alert and knowledgeable citizenry can compel the proper meshing of the huge industrial and military machinery of defense with our peaceful methods and goals, so that security and liberty may prosper together," Eisenhower said of the military-industrial power brokers of the Cold War era. 

In talking about tension between this institution and the "scientific-technical" elite, Eisenhower wisely said, "It is the task of statesmanship to mold, to balance, and to integrate these and other forces, new and old, within the principles of our democratic system--ever aiming toward the supreme goals of our free society."

Guerra questions whether the Office of the National Coordinator for Health Information Technology is the right agency to lead the push toward widespread EMR usage. In that context, ONC and CMS find themselves smack in the middle of Eisenhower's vision.

Ike's words have never been more prescient. Will the tug-of-war between the medical-industrial complex and the scientific-technical elite overwhelm, or will statesmanship prevail? - Neil

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