INTERVIEW In “iHealthBeat” ( www.ihealthbeat.org )
Coming to a RHIO Near You 
by Thomas H. Lee MD
February 16, 2007
Perhaps it's because the Oscars are right around the corner. Or maybe I've just become more jaded with time. But sometimes I wonder if the marketing hype and theatrics associated with health IT initiatives are beginning to mimic that of Hollywood. After all, didn't Steve Case from Revolution Health come from AOL Time Warner?
If it's not one hot technology, it's another. If it's not a rosy ending, it's an even rosier one. Panaceas abound, while tough work and reform remain out of the limelight.
It's difficult to say whether the current initiatives receiving mainstream media attention today will have the staying power to develop long-term, practical solutions for the future. But regardless, the current wave of Web 2.0 and personal health record promotion should provide for unique summer expectations and entertainment. Here's what you can look forward to on the big screen in 2007.
Clash of the Titans (Rated R: Sexy Market Appeal, Aggressive Language)
In this epic battle, our protagonist, WebMD, escapes its humble beginnings as a claims processing company to develop into a well-established brand among consumers, eating several other Web properties along the way. However, life is rarely placid in this "Webby World," and new characters are quick to emerge. Creatures bearing powerful search engines, formidable financiers and an army of millions quickly develop robust sites, each selling their own elixir of consumer-driven health care.
Marketing battles for content and traffic dominance ensue. An attempt for co-opetition - or "cooperative competition" -- fails. And small companies are swallowed in the fray. Who will win, and what will the new landscape look like? Will consumers stay loyal to WebMD or switch at the turn of a PHR? There is only one place where the answers can be found -- in another time, on another setting and for another feature: Clash of the Titans 2.
Freeee-Prescribing, Dude (Rated PG-13: Immaturity, Drug Overuse)
Put away those cumbersome script pads. Don't fret over minor dosing details. Escape to the wonderful world of free e-prescribing, dude. It's cheap. It's easy. And it gives you a wonderful buzz knowing that you're reducing medical errors and saving lives.
School's out for these young doctors as they enter the overwhelming reality of group practice. Prior authorization, tiered coverage, complicated dosing regimens, pharmacy callbacks. What's a physician to do?!
All seems hopeless for our cadre of idealistic young souls until a group of well-dressed suits comes to visit the doctors. Offered everything from inexpensive hardware to free Web-based prescription tools, the doctors reluctantly agree to experiment with the new drug tools. After all, could it get much worse?
What ensues is a comic array of misadventures that should only be left to your imagination. But as we know from summer flicks in the past, drugs, doctors and devices can sometimes spell disaster.
Personal Stealth Records (Rated PG: Suspense, Suspended Belief)
The year is 2007. And the race is on. To build the perfect universal PHR. The state of health care is a mess, with unnecessary medical errors and duplicative testing running rampant. Government has stepped in to help fund some bold new initiatives. And entrepreneurs and formidable giants have entered the race -- to build a PHR that patients and physicians can share, one that can integrate with EHRs and be carried on USB cards.
The pace is furious: small pilots, full-scale experiments, big bombs and incremental success. The formula is more complex than researchers predicted. And the benefits are still unclear.
Over time, a small group of winners emerge. They successfully launch a product that gets some moderate uptake. But will this be too little too late? Will PHRs be enough to stem the tide? Medical errors are already embedded deep within systems of care, and there's little to suggest that PHRs alone will win the day. Have all our efforts gone for naught?
This Plan is My Plan (Rated G: For Very General Audiences)
In this wonderfully adapted patriotic musical, singers from California to the New York Island praise the benefits of a variety of health care reform packages. Melodic themes of universal access, affordability, health IT and consumer-driven quality permeate the air. Bipartisan choruses boom from the Beltway and general optimism abounds.
As it happens in all good musicals, an ominous conflict begins to take shape. Who is going to pay for all this? Who is capable of getting the tough work done? And how will the factious, powerful lobbies actually come to meet in the middle?
The finger pointing begins, and the stakeholders find it difficult to reach common ground. The music staggers and the debates linger, and before you know it, it's suddenly 2008! Time to buy some popcorn.
About the author:
Dr. Lee is a physician entrepreneur and consultant who builds software systems and medical organizations for physicians in practice. He can be reached at tlee@metropolitan.md .
The views expressed in this column are those of the author and do not represent the views of the California HealthCare Foundation or The Advisory Board Company. 
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