Reasons Health Care IT Can’t Spend $20 Billion

I think it’s reasonable to consider some of the reasons why health care IT won’t be able or willing to have $20 billion of government money invested in health care IT.

Not Enough Healthcare IT Professionals – It’s been widely suggested that the number of health care IT professionals might not be sufficient to support this type of invesment in health care IT.  I hope my fellow IT professionals from every field can easily make the transition to health care IT.  Certainly many will without a problem.  However, the question remains if enough will be able to do so.

Other Reasons Not to Adopt EMR – I’m certain that a study on why doctors haven’t implemented an EMR yet would not show money as the main factor preventing adoption of EMR.  There are many other reasons a doctor chooses not to implement EMR and money isn’t going to resolve those concerns.

CCHIT Requirement – Of course, this assumes that the government chooses to make CCHIT a requirement for receiving funds.  Doing so will limit the choices a doctor has in selecting an EMR.  I think it’s very likely that many doctors will forgoe government funding in order to use a non CCHIT EMR.  This could be especially true for specialists who would rather select a non CCHIT certified EMR that focuses on their specialties needs.

Paperwork Required – The government won’t just be going around handing people checks.  We’ll have to wait and see how much paperwork and reporting will be required to obtain these government funds, but many doctors will shun the paperwork and beuracracy associated with receiving the government funds.

EMR Vendor Selection Process – With over 400 EMR companies to choose from, it will take doctors some time to decide which EMR they like best.  Even if you narrow the list of EMR companies to CCHIT certified companies, you’re still looking at a lengthy evaluation process.  Most doctors want to practice medicine not learn about software.  So, evaluating EMR software often gets pushed down on their list of things to do.

We’ve all seen or heard it said that it’s harder to spend $20 billion than you would think.  This couldn’t be more true when it comes to investment in health care IT and electronic medical records.  Let me know in the comments if there were any other reasons I might have missed on why the spending in health care IT might not occur.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • You make some good points here, and probably covered the majority of naysayer commentary, sad but true. I have also looked at the huge list of vendors and I wondered “Where did they all come from?”

    I suspect the list and the choices will continue to grow at an amazing rate since software vendors see the $$ opportunity.

    But the number of vendors and the choices for software aren’t the biggest problem. A larger problem is the lack of education. Doctors and Nurses are not taught how to use the computers, they are taught how to practice medicine and deliver care to patients. Add to this, the impact that technology may have on the way care is delivered (e.g. the process). There will be change and people are often resistant to change, especially when it comes in an area they don’t really understand and the change touches their daily work lives in important ways.

    I’ve heard stories of how “sloooow” it is to use EMRs or ePrescribing software. And yes, it is slow when you’re learning, or your infrastructure needs updating, or any other of the many reasons why adoption of the technology will be slow.

    I’ve even heard a physician comment that the 2% bonus may not be worth the time it takes to complete the paperwork. While all this may be true, I hope we do not loose sight of the purported longer-term benefits: better information, better decisions, better outcomes.

    Often we see only the near future and short-term problems at the expense of the overall, longer term benefits.

  • The Congressional Budget Office says that the healthcare IT incentive payments related to the House bill will be $31 billion over the next ten years, with $29 billion distributed over the next five years. After taking into account the savings for Medicare/Medicaid that stem from technology making the healthcare system more productive, the net cost of the program is expected to be $17 billion. The $20 billion price tag that the House put on the legislation is just a number. It all depends on adoption, because the payments only go to hospitals and physician practices after they have spend their own money to adopt a robust amount of software. If funding or a shortage of qualified personnel holds back adoption, then the incentive payments from the government will not be as high. It does not appear to be a wasteful plan to me.

    It seems like HIStalk lists about ten hospitals that are laying people off every week. Those people may not have a background in IT, but the do have a background in healthcare. Re-training could create part of an able IT workforce right there. There are also plenty of people out there from other industries that are looking for a job. Part of the $2 billion in the legislation that went to DHHS/ONCHIT is supposed to be directed at developing a workforce to support a greater level of IT adoption in healthcare. This will take years, but it can happen.

    If we can infuse our healthcare system with technology, improve care and put a greater focus on preventative care, then we can drive a material improvement in the average person’s health and slow the growth of healthcare spending. Stable healthcare costs and dramatically reducing conditions like obesity/diabetes would remove a significant headwind for America’s economic prosperity. It would also give us products/services that could be exported to the rest of the world, which would create an economic tailwind for our country. I know that may sound like pie in the sky, but it does not have to be if people are willing to make the commitment.

  • Deborah,
    I’m not sure if the number of EMR vendors will continue to expand. I think there are a number of reasons why the EMR industry might contract rather than expand. I’ll discuss those in a future blog post.

    I agree with you that doctors and nurses being educated in technology is a major challenge. It’s slowly getting better and better, but we still have a ways to go.

  • John Smith,
    Thanks for the information and clarification about the government’s investment in health care IT.

    I think it’s interesting that their planning for the savings to Medicare/Medicaid. If they are able to achieve any significant cost savings in those areas, I’ll be really impressed.

    I think your point about doctors footing the bill and then getting some sort of post implementation payment will also be a major barrier to spending the money in health care IT.

    Your thought about so many hospital layoff is interesting, but how many of those layoffs are health care IT staff? My guess is that most of them are not from the health care IT area.

    I do think that you’re thinking quite pie in the sky. However, it’s great to aspire for great things. I hope and every American hopes that your dream comes true in health care.

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