Lesgislating Standards or Standard Legislation?
There's an old saying that reading about music is like "dancing about architecture" -- it just can't be done. Well, I've got another one to add to list of impossibilities: "Legislating technical standards to improve patient care."
A bill has been making its way through Congress to amend the Social Security Act in order to improve patient care by reducing medical errors. This bill H.R. 4889 aims to improve patient safety by outlining a process by which organizations will be able to report non-identified, aggregated data to the Secretary of Health in order to improve outcomes and reduce medical errors. A laudable goal and, in the abstract, something that everyone should be able to agree upon (a la, "I'm for the environment, education, and peace!" Yeah, who isn't?).
Unfortunately, the last part of this resolution, authored by Rep. Johnson of Connecticut reads like this: "By not later than 2 years after the date of the enactment of this part, the Secretary shall develop (and shall periodically review and update) voluntary, national standards that promote the interoperability of health care information technology systems across all health care settings."
Wow, that's a pretty sentence, isn't it? Unfortunately, the only organization that's currently capable of enforcing "voluntary national standards" is Microsoft. When will the Government learn that a technology standard occurs through market forces, not legislation. How long have we been slogging through HL7, and any number of alternatives, with no real standard in sight?
Now, I'm not totally negative on this. The relationship between healthcare technology vendors and consumers of that technology -- whether they be doctors, hospitals, HMOs or any other healthcare organization -- has been the equivalent of boys and girls at a Ninth Grade dance. They stand at opposite sides of the gym, wanting desperately to get out on the dance floor, but they're unable to choose a partner for fear of picking the wrong one.
But...leaving it up to the Federal Government to pick the prettiest girl at the dance does not give me a lot of warm fuzzies. Take a look at how well they've done with the setting of a non-voluntary standard, digital television and HDTV. The standards have been set for years. I've owned an HDTV set for about 12 months now and about 10% of my viewing is in HDTV.
With a track record like that, I'm not sure I'm going to pick my next doc or hospital based on whether they're using government approved software.
9:28:29 PM 
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