People outside of the healthcare industry often ask, "Why can't hospitals and doctors computerize their data like other companies do, and why can't the exchange of health information be as simple as taking cash out of an ATM?"
The reason, of course, is that healthcare is a far more complex field than, say, banking or retail. But that message has still not penetrated the thinking of people who don't know healthcare.
The latest evidence of that comes from a report titled "Health IT Deployment: The Essential Role of Small IT Solution Providers." The report was authored by CompTIA, a computer industry association that represents small and midsized firms, including computer hardware manufacturers, software developers, technology distributors, and IT specialists. These companies supply and service information technology for a wide range of industries. Few specialize in health IT.
Noticing that the federal government is spending tens of billions of dollars on health IT and that jobs are growing rapidly in that sector, CompTIA's members would like to get a piece of the action. Their primary obstacles, in CompTIA's view, include:
- A lack of resources for training non-health IT professionals in healthcare
- A lack of opportunities for small computer service firms to contract with the government's 62 regional extension centers
- The latest HIPAA security provisions, which, in CompTIA's view, unfairly burden small IT companies.
Explaining the first point, the report notes that the federally funded community college training program--while necessary and important--provides only one way to meet the demand for health IT professionals. "From our experience, more attention and resources need to be provided to training existing IT professionals who already have basic IT skills but who need additional help in adding a health IT 'bolt-on' to their considerable knowledge and experience in IT." The report goes on to suggest that the government offer education tax credits or direct lending to help IT people from outside healthcare make the transition.
Considering the shortage of health IT professionals, this would be a good idea if it were feasible. The problem is that a few college-level courses in the basics of healthcare will not turn these IT people into experts who can guide a physician in EHR implementation or who could help a hospital restructure its work flow to accommodate computerized physician order entry. As one health IT consultant recently told me, a health IT professional needs deep experience in healthcare to be of any use to a hospital.
As for the ability to contract with RECs, these organizations are scrambling to find enough health IT professionals to help 100,000 primary care doctors adopt EHRs. That's the reason for the community college program. It is hard to believe that RECs would not provide lists of local value-added-resellers and computer service bureaus to the doctors they've signed up. If any do not, they should, as CompTIA suggests.
Value-added-resellers that are among CompTIA's members do, in many cases, help implement particular vendors' EHRs. There have been rumors that some RECs play favorites in deciding which EHR vendors to recommend to physicians; but, whether they do or not, it would be silly for a practice to contract with a VAR that does not have expertise in the brand of EHR that that practice has selected.
The new HIPAA rules included in the HITECH Act have increased the penalties for privacy breaches. Those penalties, which apply not only to providers but also to their business associates, can climb up to $1.5 million. But the top fines are only for egregious violations, and it's doubtful this will deter many small IT firms from working in healthcare.
The real deterrent is the gap between health IT and non-health IT. Implementation of electronic health records and other forms of health IT depends as much on a grasp of healthcare's intricacies as on technological expertise. CompTIA seems to understand that. What it doesn't recognize is that this type of knowledge is much more than a "bolt-on." - Ken