After a week of discussions on health IT, here's my take on what's missing from the Stimulus Act:

- The goal of the stimulus act is, among others, cut healthcare costs and implement strategies that are proven to cut costs. Yet, we somehow passed legislation with no talk about integrating mental health initiatives; the money is aimed for diagnositc and treatment health. Where was the meantal health lobbists that should have been harping on the Hill about the cost savings benefits of prevention and promotion programs in mental health?!

- Another key goal is to implement "interoperability ASAP" to allow the patient record to tranfer between the various organizations that touch the patient (hospital, clinics, insurance payors, drugstores, etc). So, we're going to implement interoperability ASAP, but wait, we don't even have an agreed-upon standard for interoperability. Some 300 years ago, interoperability in music was invented because someone invented the standards: it was agreed upon that there would be 8 octaves, treble clef, bass clef, sharp, flat...and today 50 musicians can gather in front of sheets of Mozart Concerto No. 9, and made music the way Mozart might have imagined. Without a standard, interoperability will be a fumbling mess. Organizations such as the Continua Health Alliance may be able to help, and I hope quickly.

- Lastly, with real money ($19.2B) behind these goals for health IT and research will be dispursed at an aggressively rapid schedule, perhaps too aggressive. The price of failure is very high, and rebuilding is difficult. There are so many organizations and moving parts in this plan, it'd be a miracle if there are no failures. Yet, no plans set in place to support implementers to try and revert on their failures.

To end on a bright note, if you're wondering why the stock market shot up yesterday afternoon, it might be due to Greenspan's statement on the last day of HIMSS: "world stocks are cheap." :)