Letters Health AffairsVol. 21, No. 6: Public Health Money Drives Resistance To IT AdoptionJerome H. Grossman AffiliationsHarvard University, Cambridge, MassachusettsPUBLISHED:November/December 2002No Accesshttps://doi.org/10.1377/hlthaff.21.6.267AboutSectionsView articleView Full TextView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions View articleTOPICSPaymentOrganization of carehealthaffHealth Aff (Millwood)Health AffairsHealth Aff0278-27151544-5208Project HOPE - The People-to-People Health Foundation, Inc.Masys DanielUniversity of California, San Diego, San Diego, California112002Public HealthThe author responds:With respect to Pawlson’s observations, the question is not whether new technologies for practice quality assessment will generate reinvigorated enthusiasm for clinical practice but whether they will have an impact on the makeup of the health care workforce. Health care needs both effective providers and the means to measure their effectiveness, and there will no doubt continue to be mixed opinions about the balance of resources applied to delivering care and to monitoring that delivery. It seems a fair assumption that employment opportunities will continue to exist in both areas.Burstin and Clancy opine that “effectively implementing this power will require that the health care workforce be viewed as an essential part of the solution rather than the problem.” This dichotomous view appears to overlook the simple truth that the health care workforce is both the source of the problem and the only plausible source of a solution. One hopes that the advance of IT will be a unifying rather than polarizing influence on the future of health care, and that the tendency to classify people as a problem or a solution will give way to an honest and dispassionate assessment of strengths, weaknesses, and needed improvements.Grossman’s observations on financial incentives that are oriented to process (such as visits or medical procedures) rather than to effective health care outcomes points to a benefit of IT that would derive from fully electronic medical records. With such an infrastructure it would be possible to link actions taken with their outcomes as a byproduct of care delivered, without the costly procedures common to health services research that is done by using manual records reviews. Individual practitioners have wide autonomy to reason in the face of uncertainty and inadequate evidence for best practices. The good news is that in the design of current systems of care, we have cleverly left ourselves room for improvement. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 November 2002 InformationCopyright 2003 by Project HOPE - The People-to-People Health Foundation, Inc.PDF download