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Lynn M. Etheredge A Rapid-Learning Health System Health Affairs, March/April 2007; 26(2): w107-w118. [Abstract] [Full Text] [PDF] [Table Of Contents] [Reprints & Permissions]

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The Fallacy Of Rapid Learning Through IT

Thomas C. Barber   ( 27 January 2007 )

The Fallacy Of Rapid Learning Through IT 27 January 2007
Thomas C. Barber, Associate physician in chief Kiaser Permanente Send comment to journal: Re: The Fallacy Of Rapid Learning Through IT thomas.c.barber{at}kp.org Thomas C. Barber	Large databases in health care are a great opportunity but can also be difficult to interpret. As an associate physician in chief in charge of information technology at Kaiser Permanente in Oakland, I have been involved in many large data projects evaluating therapies and treatments for our 3 million patients in Northern California. The size of the database is directly related to the complexity of analysis. We have 35,000 total joint replacements registered in our total joint registry, and we have run many studies looking at various practices in orthopedic surgery. We have made great strides and come out with good recommendations. These are small incremental changes which over time will provide great benefit to Kaiser Permanente and when presented at national meetings to the rest of the orthopedic community. We have been participating in this registry for five years, and we have influenced the practice of orthopedic surgery - to a small degree. These databases are critical to the success of American medicine and are important in understanding health care. They are not the answer to our health care crisis. The savings are incremental and accrue over time. They will allow us as a country to keep ahead of the rest of the world in the health care field. We should not be deluded into thinking that these databases will save American medicine - our problems of insufficient coverage and outrageous costs are beyond the incremental improvement of knowledge improvement through IT. Don't get me wrong: I fully support the development of large national databases - quality of care will improve dramatically. Our future as senior citizens depends on improving patient safety and quality of care.