Editor's Corner

Ever since the Internet was just a gleam in the eye of computer geeks at the Department of Defense in the 1960s we've been stumbling forward two steps only to fall back another step, or three, in the sometimes twisted, always painful lurch toward broad healthcare IT standards. It's a frustrating situation because most everyone agrees that a lack of standards is slowing the adoption of technologies that will save lives, time and money. Unfortunately, the bulk of the agreement stops right there.

In an excellent and thought-provoking opinion piece last week, Olga Pierce of United Press International notes that "there are currently more than 4,000 health IT standards in use, with hundreds of bodies responsible for them--no wonder then, that doctors and other healthcare providers--who are being asked to invest tens and even hundreds of thousands of dollars--feel a little like they are putting their money on the roulette wheel."

As Pierce points out, many standards advocates are calling for a "national conversation" on health IT standards. So far, so good. Except this is also a nation that apparently can't agree on which horse to back in much of anything, such as the theory of evolution versus scientific design, whether domestic spying is okay or a threat to civil liberties, or even Batman versus Superman.

When it comes to adopting standards, Pierce correctly and diplomatically points out that the big problem is that there are "different schools of thought" on what role government and markets should play in deciding which standards pass the test of time.

The distressing end result is aptly summed up in Pierce's piece: "Why would I want to install a system that costs $30,000 per physician if in two years it's going to be obsolete, or the vendor is out of business, or it doesn't do what it says in the brochure?" Rod Piechowski, vice president of the National Alliance for Health Information Technology, told UPI after a recent congressional briefing. "The problem is not that we need standards; it`s that we have to decide what standards we`re going to use." (To join the debate, visit this site.) - Michael