Another E-Health Project In Disarray

Partners in initiative known as Dossia squabble over money, deliverables. Will the health industry ever get this right?
Dossia is the largest employer coalition attempting to provide workers with private (the companies won't have access to patient data), secure electronic health records. But it's not the first e-health program to encounter major problems, which have included lack of funding, doctor apathy, concerns about patient privacy and medical liability, and technology glitches.

Among the highest-profile disappointments was the Santa Barbara County Care Data Exchange, a $10 million project launched in 1999 to let doctors, labs, hospitals, and other health care providers in Southern California share patient data over a secure, interoperable network. The project, which served as a model for other regions developing health data exchanges, had ushered into the national spotlight Dr. David Brailer, former CEO of software developer CareScience, the prime contractor on the project. Brailer in 2004 was named the country's first national health IT czar, a sub-Cabinet position created by President Bush to help meet his goal of creating electronic health records for most Americans by 2014.

The Santa Barbara exchange--which was much further along in development than Dossia's system is now--eventually got dragged down by legal issues and competitive concerns among health care providers. The exchange folded last year after doctor interest and funding waned.

When the Dossia project was announced last December (around the same time the Santa Barbara exchange was shut down), health officials from across the country lauded the effort as a major step toward digitizing the industry. Dossia's blue-chip companies, which spend billions of dollars a year on health care, were seen pressuring tech-laggard medical providers into adopting e-health systems of their own.

In testimony before a subcommittee of the U.S. Department of Health and Human Services in January, Carolyn Walton (no relation to Mr. Sam), Wal-Mart's VP of information systems, talked about the company's high hopes for Dossia.

"Dossia is a first-of-its-kind collaboration between Wal-Mart and other employers, and it represents an important first step toward bringing greater efficiency, quality, and transparency to the U.S. health care system," Walton testified. "Dossia will provide Wal-Mart associates and employees at other founding companies with a framework through which they and their doctors can both build and maintain private electronic personal health records. With employers paying almost half of all U.S. health care costs, Dossia will be an important component in making the health care system more efficient and effective, eliminating waste and duplication of effort on behalf of consumers and providers."

For Dossia to move forward in eliminating that waste and duplication of effort, it will have to get its internal house in order. If history is any guide, that's a lot easier said than done.

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