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At "Background On The 'Ecosystem' of Commercial Healthcare IT" I wrote:

... In reading about HIT difficulties it is important to understand the “ecosystem” of commercial health IT, that is, the identity and nature of the principal constituents and stakeholders, and their interrelationships. Familiarity with this environment is useful in order to place the social and organizational issues affecting HIT diffusion in the proper context.

By implication, I made the case that the commercial HIT ecosystem was far from healthy.

Recently at Healthcare Renewal and at another blog I visit, HISTalk, frequented largely by IT industry workers and officials, I've noted an uptick in comments from anonymous commenters that resort to ad hominem, strawman arguments, or other forms of logical fallacy in a fairly clear cut attempt not to seriously debate the issues but to de-legitimize serious arguments. I generally respond to such comments, but a few have been so debased here that I have simply deleted them.

Here is an example of a duplicitous strawman argument recently posted at the aforementioned other site with regard to my HC Renewal post "21st century EMR experiments: screwing around with people's lives in a broke city, while not having a clue what you're doing":

... Jumping to conspiracy theories about cover-ups whenever there is an IT problem acknowledged by an organization does not really help improve the state of health IT.

I find the sicknesses of the commercial health IT ecosystem very disappointing and, in fact, revolting due to the implications for patients.

Perhaps a little background as to why I feel that way is in order.

Note:

I believe my background is not too dissimilar from the background of many physicians, who have had similar experiences. The following is therefore not so much about me, but about the challenges of medical training and practice in general and the life experiences imparted:

Pre- informatics, while a resident at Abington Memorial Hospital in Pennsylvania and then as a Manager in a regional transit authority’s medical department, I handled situations such as these:


Experiences such as this impart a sense of the fragility of life, of responsibility, obligation, and an understanding of the need for critical thinking and serious and uncompromising attitudes where patients are concerned into physicians of good character.

(Somehow, the hospital, pharmaceutical and medical device executives written about at Healthcare Renewal seem to have missed those points in their own life experiences.)

Most serious, critical-thinking physicians thus would find irrational arguments coming from the HIT industry, marketing spin, petty character attacks on those who report on HIT difficulties, and other unpleasantries quite unserious and disappointing. I certainly do.

After all, IT industry personnel in large part went through educations far simpler than that of a physician. They generally have bachelor's or masters' degrees, have had no medical school experience, internships, residencies, postdocs, etc. They have what are essentially comfortable desk jobs, no liability for patient harm, and compared to most physicians, a cakewalk in their professional lives.

On the other hand, as a physician who had such experiences, I’m a serious professional concerned about serious issues that affect people's lives in their time of need.

I expect nothing less from others involved in aspects of healthcare that can be life or death (as my own mother recently experienced via EHR-initiated iatrogenic catastrophe).

From that perspective, I find the commercial HIT ecosystem quite debased indeed.

-- SS

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