Editorial: HIMSS Prefers Unacceptable Status Quo

HIMSS response, while predictable, is misguided on so many levels that it is difficult to know where to begin. The official response says: '...The private sector makes significant investments in research and development for healthcare IT products. Healthcare IT is available via a competitive market in which vendors compete on the basis of price, quality, and functionality of a product. The development, routine updating, and provision of an open source “healthcare information system” is not the role of the federal government and such product development should remain in the private sector...'

HIMSS: '...The private sector makes significant investments in research and development for healthcare IT products...'
Response: So has the federal government. In a big way over decades with a proven track record of success. The private sector can in no way match the investment in both tax dollars and time that has already been done in the Veterans Affairs VistA system over decades. Medicine is a supremely complex undertaking. To adequately computerize healthcare as the VA has already done requires billions of dollars and decades of time with a singular focus on the care of the patient by health IT workers and clinicians working side by side. This is the type of investment that the private sector has not done, nor can it adequately do and possibly may never be able to do.

HIMSS: 'Healthcare IT is available via a competitive market in which vendors compete on the basis of price, quality, and functionality of a product.'
Response: False. Proprietary Electronic Medical Record software is not a free market. Important information about proprietary software is a trade secret, hidden from customers in order to lock them in to their products. True side by side comparison of proprietary Electronic Medical Record software is generally not done or nearly impossible to do because of expense and trade secrets. Traditional markets offering proprietary Electronic Medical Records have failed for decades to provide the quality and functionality at a reasonable cost that is desired in medicine. That is because Electronic Medical Records software are a public good like a lighthouse, not a private good like cars of furniture. Yet the HIMSS response ignores this fundamental understanding of markets and will simply continue the decades of failure. Some things like Electronic Medical Records need some help from the Federal government to establish a true market. Real markets have vendors that compete on the quality of their service, not on keeping its customers captive with proprietary software that medicine has largely rejected and will continue to reject.

HIMSS: 'The development, routine updating, and provision of an open source “healthcare information system” is not the role of the federal government and such product development should remain in the private sector'
Response: This is a distortion on HIMSS part. The bill calls for the federal government to 'coordinate' these activities which is not the same as actually doing the activity itself. Furthermore, the grassroots programmers in the VA have already created a successful national health information technology infrastructure. This is something that traditional markets, years of wishful thinking, HIMSS with all its glitzy conventions and booth babes has not done and likely never will. Finally, the lines between private and public in United States health care has always been blurry. Purely private health care is an idealized fiction. To draw such a sharp distinction that it should be all private is merely showing the fear that HIMSS corporate membership has that its failed proprietary business models are being threatened.

In conclusion, while traditional private markets are desirable for many things and federal government intervention is generally undesirable, there are times like this when it is desirable and necessary for the federal government to intervene to establish a true market. HIMSS should welcome this bill and its open source provisions so that real customer value can be created and a very dark era of abysmal adoption rate of life-savings health information technology can come to an end.

<  |  >