In case you've missed out, a flurry of articles have come out this week on the efficacy of health care information systems technology.  What's the take away?  To quote the HIStalk guy, "it isn't what you have, its how you use it." I would add to that, "its what you chose to bite off too." Go for the low hanging fruit first -- the apps with clear ROI and manageable implementations -- there's so much more to be done at the point-of-care.  Its like health care wants to skip the most effective and realistic projects and jump straight to "bet the farm" projects.  Sadly, CIOs will lose jobs, and HIT will lose credibility, as a result.  Manufacturing and industry spent years implementing IT projects of limited scope and strong ROI before tackling ERP and CRM.  Is CPOE is the CRM of health care -- a super expensive, high risk project that ends up with little or no benefit for most but vendors and consultants? Over half (61%) of the CRM reference sites on Siebel's own web site said they, "did not believe they had achieved a positive ROI from their Siebel deployment."

PricewaterhouseCoopers/HIMSS Analytics study praising HIT as the solution to financial and patient safety problems. (The actual study here, requires free registration.)  Their poster child, Indiana Heart Hospital, was built from scratch as a "digital hospital" -- not  an implementation strategy available to most hospitals.

"An AHRQ study proves what most of us already knew: when it comes to CPOE, it isn't what you have, but how you use it." [From HIStalk] 

Then there's this JAMA study on CPOE, also demonstrating that no application is a panacea.  And here's a NYT story following up on the JAMA study (free registration required).

Forbes writes about the dark side of "wired" hospitals, echoing AHRQ and JAMA above.  CNN gets in the act too.

3/14/05 UPDATE: Healthcare IT vendors respond to the JAMA article above. After grumbling and disparaging the study, ends on these points:

Nearly all the vendors interviewed agreed that the silver lining in the CPOE study storm cloud was clarifying that technology alone won’t solve problems and that hospitals implementing CPOE should take a hard look at their own workflows. “It will open some eyes to make sure that what they buy lives up to their needs and expectations,” said Meditech’s Sayed-Friel. “It highlights possible pitfalls and should prompt hospitals to ask vendors tough questions.”

3/18/05 UPDATE: Now the HIT consultants get into the act. Give the high cost, apparent risk and obvious complexity of CPOE, consultants seem to have a motivating interest in seeing CPOE adoption continue to increase.