After reading the parts of the American Recovery and Reinvestment Act of 2009 that relate to health IT, here are my conclusions: 1) More of the same. The current plans and all the same players for Health IT as before only now there is a lot more money involved and a brief time to accomplish all of this in terms of health care time: 2014. 2) A chicken in every pot approach, everyone gets money: education, Health IT schools, some physicians get money for implementation on a descending rate. Some talk of free/open source but the usual political favorites AHIC, etc. are all still there as well only they get a lot more money now. 3) No clear plan as to how to do all this. No clear plan for dealing with issues such as 20 year veteran clinicians and nurses with no computer experience. No plan for enabling the proliferation of innovative software with existing systems. No penalty or plans for dealing with proprietary software stonewalling.

Predictions: as feared, this may just inflate the balloon of what is already there now: a mish-mash of different systems. The only difference is that they’ll have to be CCHIT certified which is a weak certification and favors larger players. This seems like it will advance the formation of expensive cartels which eventually become expensive monopolies while stifling innovation in general and innovation of small players in particular.

This is likely to have very adverse consequences for privacy and greatly weaken the role of the physician as the traditional custodian of medical information.