AMIA 2010: 'Five to 10 years away' always seems five to 10 years away

Health IT always seems to be five to 10 years away from radically transforming what passes for a healthcare system in this country. If you recall, Dr. David Brailer's national health IT strategy was based on President George W. Bush's 2004 goal of delivering interoperable EMRs to most Americans by 2014. President Barack Obama, upon taking office in 2009, reiterated the 2014 target date, but raised the goal to all Americans.

I'll have more tomorrow in FierceMobileHealthcare about some lofty prognostications from last week's mHealth Summit. Today, though, I'd like to draw your attention to some comments made Sunday by Dr. Don Detmer, immediate past president and CEO of the American Medical Informatics Association.

AMIA's American College of Medical Informatics presented the recently retired Detmer with the Morris F. Collen Award of Excellence, named after a nonagenarian pioneer in biomedical informatics. (At least one former AMIA board member has a cat named after Collen.)

In 1991, Detmer was chairman of the Board on Health Care Services of the Institute of Medicine when the IOM issued a landmark--but largely ignored--treatise on what then was called the "computer-based patient record." (Detmer said Sunday that he arrived at the title based on Collen's advice that the focus be squarely on the patient. Could it be that champions of EMRs and EHRs have forgotten about the patient?)

As Detmer explained Sunday, the committee that wrote "The Computer-Based Patient Record: An Essential Technology for Health Care" (1991, revised 1997) thought it would take 20 years for EMRs or EHRs or CPRs or whatever you wish to call them to become the standard of care in America. Detmer, one of the report's three editors, reasoned that the American people weren't quite that patient, so the IOM ultimately set a goal of replacing paper records within 10 years. "I knew that it was probably unattainable," he said.

Obviously, we didn't hit that 2001 target. As 2011--20 years out--looms less than two months from now, it's clear the IOM committee's wishes won't come true. It's looking pretty doubtful that the Bush/Obama goal of 2014 will happen, whether you're shooting for "most" or "all" Americans.

It's always good to aim high, but history has taught us to take such predictions with a grain of salt. - Neil