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Commentary

An IT Trojan horse ... Feds should stay out of ‘evidence-based’ medicine
Regina E. Herzlinger, Modern Healthcare, 9-14-04

Regina Herzlinger, Harvard Business School professor and Manhattan Institute senior fellow, argues that new federal regulations designed to create standard formats for electronic patient health records are really a Trojan horse for the creeping government control of medical practices and standards.

Once Washington bureaucrats have standardized data in hand, Herzlinger fears that they will use the government's enormous purchasing power to dictate the process of care rather than outcomes. She notes that "because the [health care sector] has few accepted measures for risk-adjusted quality outcomes – the death and illness rate of different providers – [policymakers will] focus instead on the process care. Those judged as low performers because they do not comply with the federally mandated processes will be financially penalized in an initiative dubbed 'pay for performance'."

Herzlinger thinks that rather then micromanaging physician practice, the government should provide risk-adjusted health information that compares outcomes at different providers, and then let consumers reward high performers with their health dollars. This approach will reward providers for health care innovation, rather than their skill at jumping over government hurdles.



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