Benefits Buzz

Jack of All Trades & Master of None

Poor focus hampers wellness implementation.

Are you updating your facebook status via Twitter from your iPhone as you apply your make-up or eat your burger on the driveto your next open enrollment meeting?  Many Americans feel as though they are good at multitasking and engaging in multiple activities simultaneously leads them to believe they are accomplishing more. 

In her book, Distracted: The Erosion of Attention And The Coming Dark Age, author Maggie Jackson points to a growing body of research studies that seem to suggest the opposite.  A flood of stimulation, interruption and fleeting human contact have created a culture of "diffusion, fragmentation."

She points out the consequencesof what most of us consider par for the course in our lives and working environments:

Interruption and the knowledge worker:

• Knowledge workers switch tasks every three minutes. And once interrupted, a worker takes an average 25 minutes to return to their original task, according to informatics scientist Gloria Mark.
• How often are we interrupted?  The average worker gets 156 emails a day, according to the Radicati research group. And that's just the beginning; instant-messages, phone calls, faxes and snail mail add to the influx.

Making a national habit of multitasking:

• Sixty-five percent of people eat while they drive.
• Sixty percent of kids age eight to 18 multitask some or most of the time they're doing homework.
• Twenty-five percent of restaurant meals are ordered from the car, up from 15 percent from 1988.
• American kids are exposed on average to nearly six hours a day of non-print media.
• Two-thirds of children under six live in homes that keep the tv on half or more of the time, an environment linked to attention-deficiencies.

Time and time again in the world of wellness we see this habitual tendency toward mindless overcommitment, interruption, and multitasking lead to programs that are too diffuse to do much good if the desired outcome is a healthier workforce and reduced health care costs.

Why wellness fragmentation does not equal results

How does ROI for wellness work?  It is more of a cost avoidance than an actual savings in most cases.  Here is a simple (and maybe a little too simplistic) example to help walk you through the "savings." 



Half of your workforce participates in a risk based population health strategy (wellness program) and the other half does not.

For the participating half of the population, whose risk is known, you are able to offer outbound (active) and passive programs that directly impact and address the risks you've identified as prevalent to this group. 

Let's say the programs you've implemented are effective, engagement in them is high, and you retain these employees.  Over a series of years you should see something happen that is counter to what will have happened with no intervention. 

That is to say, this group will not get sick as often as non-participants because your interventions were effective and employees stuck around long enough for you to see results.

The non-participants at your company, as an aggregate, are an unknown entity to you.  You have very little data on their risks and, as a group, they will most likely continue to use health care at the same rate as before. 

Yet, if your company-wide wellness communications are effective and appealing, your participant group is vocal and influential, and your non-participants stay at your company without developing any major illness then some studies indicate that your wellness program might actually have a halo effect. 

That is to say, even non-participants will learn a little more about self care whether they participate or not.  Sure, that could slow the rate of health care cost growth in that group, though probably not by a lot.

Both groups' cost trends together is your overall trend.  Both may continue to rise, but your participant group's trend over several years will rise more slowly - making your overall costs appear to grow more slowly. 

UNLESS.  Yes, there is an unless.  Unless, your participant group is so small and the growth in the cost of health care is so large that your non-participants' health care usage effectively nullifies any impact you had on participants.    

Wellness is not Wii Fit.  You need to focus.

As much as we know that on an individual level good health is as simple as: sleep well, eat right, and move more, achieving a successful organizational wellness strategy is as much an art as it is a science.  It takes focus, discipline and rigorous measurement to impact behavior, motivate and sustain participation, and to quantify results.

If your program is to be successful then you will need to engage a large chunk of your workforce, stratify their risks, and follow a disciplined series of stepsover several years in order to see return on investment.  Oh, and do all of this while simultaneously carrying out the core work of your company.

Fight the urge to multi-task

While multi-tasking may be transitioning out of vogue when it comes to work effectiveness, its cousin  - work sequencing - can help break large and complex tasks into more manageable pieces. 

Plan to succeed by drafting a multi-year strategy with a realistic timeline.  Schedule monthly (core team), quarterly (key shareholders and decision makers) and annual reviews (company wide) of a the wellness program before you even begin work.  This will hold you accountable for reporting progress toward implementing your strategy and plan. 

Build up to maximum efficiency by starting with only a few key program components that will get you the most bang for your buck.  Gradually add complexity as your initial program begins to show results. 

More often than not, companies initially underestimate how much time it takes to implement a strategic wellness program.  They allocate too few resources and take on too many program components to ever really get much traction.  As a result, their programs suffer from poor participation due to fragmented management and the overall program shows high attrition.  Plan intelligently and sidestep this common trap.

Editor's Note: By day, Kris Dunn is the VP of People at DAXKO, a cool software firm dedicated to providing solutions to the best membership-driven organizations in America. At night, he morphs into a blogger at The HR Capitalist and the Founder and Executive Editor of Fistful of Talent. That makes him a career VP of HR, a blogger, a dad and a hoops junkie, the order of which changes based on his mood. Tweet him @kris_dunn...

Sunscreen Arms Race - How About a 500 SPF Product?

For those of you who haven't met me, to classify me as pasty is fair.  Irish blood has made me that way, which means I need some sunscreen protection when it's beach or pool time.  I've long since given up on the bronze tan, I'll settle now for people not squinting if they look my way, as the sun deflects off of my skin like it was aluminum foil.

Given my history as pasty-man, I've grown skeptical of the need for even 50 SPF sunscreen.  After all, if I burn in 20 minutes without sunscreen, 50 SPF means I have the ability to stay out in the sun (properly applied with no water erosion) for 1,000 minutes, right? 

As it turns out, there's a SPF marketing arms race that's going on right now.  More from the New York Times:

"LAST year, Coppertone rolled out two easy-to-use sprays with its highest-ever sun protection factor: SPF 70+. Not to be outdone, Neutrogena offered its Ultra Sheer Dry-Touch lotion in SPF 85 strength, that year’s big gun.   This sun season, Banana Boat is retaliating with a pair of SPF 85 sprays, which it trumpets on its Web site as “our highest SPF level in a continuous spray formula.” 

But now, SPF creep has hit the triple digits with Neutrogena’s SPF 100+ sunblock, leading some dermatologists to complain that this is merely a numbers game that confuses consumers.  The parade of stratospheric SPFs is “crazy,” said Dr. Barbara A. Gilchrest, a dermatology professor at Boston University School of Medicine. “For a normal person who is fair-skinned and concerned about skin damage and photoaging,” Dr. Gilchrest said, “it’s really in my opinion tremendous overkill.”

But that’s not necessarily the case. No SPF, not even 100+, offers 100 percent protection. What’s more, both UVA and UVB radiation can lead to skin cancer, which is why dermatologists now advise using sunscreens with an SPF of at least 15 and UVA-fighting ingredients like an avobenzone that doesn’t degrade in light or Mexoryl SX.

The difference in UVB protection between an SPF 100 and SPF 50 is marginal. Far from offering double the blockage, SPF 100 blocks 99 percent of UVB rays, while SPF 50 blocks 98 percent. (SPF 30, that old-timer, holds its own, deflecting 96.7 percent)."

Good to know.  Remember, when you see me on the beach, be sure your sunglasses are on.  The glare can be blinding...

Editor's Note: By day, Kris Dunn is the VP of People at DAXKO, a cool software firm dedicated to providing solutions to the best membership-driven organizations in America. At night, he morphs into a blogger at The HR Capitalist and the Founder and Executive Editor of Fistful of Talent. That makes him a career VP of HR, a blogger, a dad and a hoops junkie, the order of which changes based on his mood. Tweet him @kris_dunn...

Fat Is the New Skinny - Trends in Classifying Yourself As Overweight...

That's right.  Our kids have been fat so long that our expectation of what fat is has started to shift.  See this research abstract from Burke, Heiland and Nadler and exhale:

"We test for differences across the two most recent NHANES survey periods (1988–1994 and 1999–2004) in self-perception of weight status. We find that the probability of self-classifying as overweight is significantly lower on average in the more recent survey, for both men and women, controlling for objective weight status and other factors. Among women, the decline in the tendency to self-classify as overweight is concentrated in the 17–35 age range, and, within this range, is more pronounced among women with normal BMI than among those with overweight BMI. Among men, the shift away from feeling overweight is roughly equal across age groups, except that the oldest group (56–74) exhibits no difference between surveys. In addition, overweight men exhibit a sharper decline in feeling overweight than normal-weight men.

Despite the declines in feeling overweight between surveys, weight misperception did not increase significantly for men and decreased by a sizable margin among women. The shifts in selfclassification are not explained by differences between surveys in body fatness or waist circumference, nor by shifting demographics. We interpret the findings as evidence of a generational shift in social norms related to body weight, and propose various mechanisms to explain such a shift, including: (1) higher average adult BMI and adult obesity rates in the later survey cohort, (2) higher childhood obesity rates in the later survey cohort, and (3) public education campaigns promoting healthy body image. The welfare implications of the observed trends in self-classification are mixed.

Hat tip to Marginal Revolution...

The Bun In The Oven & The State of Preventative Health Care...

Here are some snippets from an email I received from the US Department of Health and Human Services today:

"We know that the health care crisis impacts every American, but our mothers, daughters and sisters are paying a particularly heavy price. Today, 21 million women and girls are uninsured. Women who try to purchase insurance find that the private market is often stacked against them. Premiums in the private market for young women are often higher than they are for men. In some states, insurance companies can legally discriminate against women, and leave them with higher health care bills or inadequate coverage.

We know America's women can't afford to wait for comprehensive health reform. Roadblocks to Health Care reports:

• In the individual insurance market, women are often charged higher premiums than men during their reproductive years. Holding other factors constant, a 22 year old woman can be charged one and a half times the premium of a 22 year old man.
• In a recent national survey, more than half of women (52%) reported delaying or avoiding needed care because of cost, compared with 39% of men."

Why are women charged more?
Among other things, because we can get pregnant and pregnancy in the US is very expensive. We therefore use more health care and are charged more or denied insurance coverage. But here is the crazy part, folks: women cannot self-impregnate!

Not long ago, I received a very personal lesson on the wacky state of preventative health care for maternity. As an otherwise extremely healthy person with a good track record for taking care of myself and little in the way of worrisome health risks, I'd gone the way of financial prudence. I purchased a health plan with a high deductible, but with inexpensive co-pays on doctor's visits and alternative medicine as well as discounts on pharmaceuticals, should I need them.

This was all working out very well. I continued to do my part for the team by taking good care of myself, paying my insurance company dutifully and not using any medical care! I was mentally prepared should a catastrophe befall me. I figured, should that happen, my piddly $5k deductible would seem like chump change in comparison to what I would otherwise have had to spend out of pocket for catastrophic care. All those years of paying unused premiums to my carrier would have been put to good use!

Then, about 6 months ago I developed a small "medical" problem. That's right. I got pregnant. Ok, so this is no catastrophic illness or disease condition, right? I mean, there are more than 6 billion people on earth and, unless I am mistaken, pregnancy is the way we all got here. As a scientist, I will grudgingly agree that pregnancy looks suspiciously like a highly evolved parasitic infection. Yet, unlike malaria - for instance - my health plan wasn't ponying up any cash for pregnancy vaccines or other preventative measures against this "disease."

So, it was one $20 co pay with my primary care doc, the cost of a pregnancy confirmation test, and then I was on my own. At that point my options were to start clocking maternity care against my catastrophic deductible. After meeting that limit I'd pay 30-70%. After doing the math, I realized that if I ended up in a hospital for a routine, healthy birth, with no serious complications, that I would most likely end up paying $7,500+ out of pocket for my "disease."

Compare this to a $2000-2500 bill if I pay cash for a home birth with a certified nurse/midwife, including all prenatal scans and labs and two months of well baby care, and it left me scratching my head. Now if there were complications (need for surgery, premature birth, gestational diabetes, preclampsia, etc.) that led to a need for emergency medical intervention then, as I said, there is not much room to gripe over the deductible when so many dollars and someone's life are on the line. Yet when all signs in my case (and in the case of nearly 75% of pregnancies that come full term) point to a completely normal, healthy pregnancy and birth, I am perplexed about how this situation serves any sort of greater good.

In my case, I simply opted to pay the midwife out of pocket and should an emergency arise, well, it's an emergency - deductible be damned. Yet I think about all of the women whose partners may have left them; women whose partners lost their jobs; women who have lost their own job and are not sure how to afford COBRA, but would be denied individual coverage due to their "pre-existing condition"; women who are short on the cash to be able to afford the relatively less expensive but still cost prohibitive bill for good prenatal care and who end up with very costly bills later on down the line due to having delayed or avoided care.

And these mothers who were impregnated by partners who - in most cases - will not be denied coverage or see rate increases due to their partners' "disease," are left unable to pay and to pass on the costs to the remaining payers in the current insurance system - thus becoming contributors to the astronomical rise is insurance rates. These are not some handful of bad people "out there." If you are reading this blog, breathing and have a pulse right now then you have a pregnant woman to thank.

People are not going to stop making more people, people. It just isn't going to happen. So what are our options when it comes to taking pregnant women off of the bad apple list with regards to health care costs?

1. Provide safe, effective and affordable contraception and family planning services to women of reproductive age (yes, this means after menarche) .
2. Ensure that pre-natal care is covered as preventative care under health plans.
3. Stratify pregnancies by risk and ensure that health plans cover lower cost but safe and effective birth options such as licensed birthing centers and midwife assisted home births for low risk pregnancies.
4. Ensure that health plans rapidly identify and direct high risk pregnancies to maternity care and coaching programs that help manage behavioral risk factors and more closely monitor pregnancy through birth.
5. If you are an employer providing maternity benefits and health insurance for your employees and spouses, make sure you emphasize prental care and maternity benefits offered by your health plan. Consider setting aside lactation rooms to encourage breastfeeding mothers to pump so that they can continue to feed their babies breastmilk (which has health benefits for the mother and child).
6. Support legislation that accomplishes all of the above and funds community health education centers that provide outreach, education and services to uninsured populations - eliminating a cost barrier which might keep pregnant women from seeking care until it is too late.

If altruism isn't your bag, then consider that early prenatal care helps all payers in the health insurance game by lowering costs shared by the pool. And if you are still feeling the glow from that gift that had your mom in tears last weekend, then - hey - do it for the lady who loved you enough to endure nausea, swollen feet, ill-fitting clothes and a whole lot more to bring you into this world.

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

Alabama Teachers - Wellness is Gone, and Don't Smoke 'em If You Got 'em...

When push comes to shove on the benefits front, what's the first thing to go?  Select from:

1.  No price increases;

2.  Nice to have things like wellness programs; or

3.  Allowing people to smoke without charging them more for benefits...

If you're the group that administers benefits to Educators in Alabama, you dump wellness and start charging the smokers more.  From the Montgomery Advertiser:

"The board of the Public Education Employees Health Insurance Plan de�cided Friday to maintain the same basic rates for active employees: $2 per month for individual coverage, $132 for dependent coverage and $134 for family coverage. The rates for retired education employees will also stay the same.

The board unanimously raised the surcharge for smokers by $2 per month to a total of $25 starting Oct. 1. That affects about 20,000 people.

As a cost-saving measure, the board voted to eliminate all of its wellness program except flu shots. Deputy Director Marc Reynolds said eliminating health screenings, osteoporosis screenings, Weight Watchers and other features of the wellness program should save $3.5 million in the new fiscal year. But he said it could be more costly in the long run if illnesses are detected later and the treatment is more expensive.

The board had to look for cost savings and revenue generators because the education budget passed by the Legislature on Thursday provided for no increase in funding for health insurance for the 284,655 active and retired employees and dependents who have coverage. The Legislature did that, at the request of the Alabama Education, to put as much money as possible toward maintaining school jobs during the recession."

Interesting to see if wellness comes back to this group or if it's gone forever.  Still pretty good monthly rates for gold plated coverage though...

What Would You Do If Your CEO Got Swine Flu?

Get Well Soon, CEO!

Finding an executive manager is never easy. And once you do find a fearless leader, myriad cultural, economic and - yes - even personal health issues can threaten to throw the whole situation off the rails.

"The impact of replacing senior managers, especially due to sudden health issues, is even more acute than normal turnover. A study by Deloitte shows that 47% of companies cite their biggest people-related challenge as leadership development and succession planning," says Candie Fisher,Director of Client Development for Generator Group, a talent management firm based in Portland, OR

Steve Jobs' much publicized cancer struggle sent off a flurry of speculation about Apple's readiness to replace him.  Last year,CFOs at nCipher and Servocell resigned due to ill health. In 2004 McDonald's CEO, Jim Cantalupo died at age 60 of a heart attack. Charles Bell, who replaced Cantalupo, was diagnosed with colorectal cancer only a month after being named chief executive. 

And while the press might not have noticed that your company's top brass was 'not strong enough' to attend a meeting, that's just the kind of news that makes fine grist for the company rumor mill.  If people are worried about your firm's financial performance, an ailing leader's plight isn't exactly the kind of news that will boost productivity. 

Executives Are People, Too!

Despite their strategic importance to an organization, executive leaders are in many other ways just like everyone else. They have bad hair days (case in point, get a load of Bill Gates and the Microsoft crew in this photo)!

They get sick - often due to preventable causes - just like the rest of us.

Sharon McDowell is an exercise physiologist for the Center for Creative Leadership's Leadership At The Peak Program. The program has looked at the overall health of senior executives and leaders with more than 15 years of management experience, in the top three tiers of the organization, with leadership responsibility for 500 or more people and/or executive staff functions. McDowell says that of the nearly 3,000 program participants screened 58% had high cholesterol; 60% are overweight or obese; and about 50% don't exercise regularly.

Executive managers lead high stress lifestyles and often lack the time for structured exercise. The World Heart Federation and the US Federal Centers for Disease Control say failure to exercise is as bad as smoking a pack of cigarettes every day.

Unexpected leadership transitions are costly, says Fisher, "At the top levels, many companies do not have a strong program in place to fill senior leadership positions from within. As a result, fully-loaded recruiting costs of 1.5 times the annual salary are commonplace."

Fisher recommends companies implement a two-pronged strategy of keeping their senior managers focused on both wellness and succession planning. "Executive level jobs can be stressful, reducing executives health risk through wellness programs can increase leadership productivity thus improving their ability to mentor, groom, and retain high potential talent," she states.

Increasing executives' personal well-being might also improve their effectiveness. McDowell's research has shown that executives that exercise are more likely to be perceived as more energetic and effective than their non-exercising peers in 360 degree management surveys.

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

Alabama - Now Charging Obese Workers More For Benefits....

I've written a lot in the past about the continuing escalation of healthcare costs in the U.S. forcing companies into a corner, a corner which will force them to either penalize unheathly employees or reward healthy employees for their health metrics.

Whether you use the carrot or the stick will be up to you.  But employers are increasing their moves to link employee heathcare premiums to metrics like blood pressure, cholesterol, blood glucose, obesity, etc.

The state of Alabama recently annouced some changes that suggest you'll have your BMI memorized in 5 years.  From MSNBC....

"Alabama, pushed to second in national obesity rankings by deep-fried Southern favorites, is cracking down on state workers who are too fat. The state has given its 37,527 employees a year to start getting fit — or they’ll pay $25 a month for insurance that otherwise is free.

Alabama will be the first state to charge overweight state workers who don’t work on slimming down, while a handful of other states reward employees who adopt healthy behaviors. Alabama already charges workers who smoke — and has seen some success in getting them to quit — but now has turned its attention to a problem that plagues many in the Deep South: obesity.

The State Employees’ Insurance Board this week approved a plan to charge state workers starting in January 2010 if they don’t have free health screenings. If the screenings turn up serious problems with blood pressure, cholesterol, glucose or obesity, employees will have a year to see a doctor at no cost, enroll in a wellness program, or take steps on their own to improve their health. If they show progress in a follow-up screening, they won’t be charged. But if they don’t, they must pay starting in January 2011.

“It’s terrible,” said health department employee Chequla Motley. “Some people come into this world big.”  Computer technician Tim Colley already pays $24 a month for being a smoker and doesn’t like the idea of another charge.  “It’s too Big Brotherish,” he said.

The board will apply the obesity charge to anyone with a body mass index of 35 or higher who is not making progress. A person 5 feet 6 inches tall weighing 220 pounds, for example, would have a BMI of 35.5. A BMI of 30 is considered the threshold for obesity.  The board has not yet determined how much progress a person would have to show and is uncertain how many people might be affected because everyone could avoid the charge by working to lose weight."

Welcome to the brave new world.  I'm a proponent of rewarding employees who live healthy lifestyles that result in reduced risk.  Still, I wonder if $25 per month ($300 per year?) makes enough of a dent.  My take is that the psychological threshold for action is triple digits - $100 per month. 

Put the doughnut down.  Doughnuts are for closers people who exercise... Not for those who think the Wii Fit is a good exercise tool...

How Are Benefits Managers Responding to Tough Economic Times?

Chances are, given current economic conditions, you aren’t rolling out many new benefits this year.  In fact, you’ve probably received direction from your e-suite to “cut costs” without much direction regarding where those savings should come from.  There’s a fine line that folks who work in benefits are walking these days.  On one hand, we’re looking for opportunities to control or cut costs.  On the other, we want to continue offering benefits programs that help attract and retain talent.  The challenge is finding ways to balance these competing interests.
 
If you believe the media, the easy cut for many employers is the employer match on 401k contributions.  Others are making changes to what they contribute toward medical coverage or changing medical plan design.  Still, others are moving away from traditional health coverage altogether toward consumer driven health plans (CDHP).  In a recent survey, Watson Wyatt found that 51% of employers responding currently have a CDHP in place -- up 9% from the prior year.

While it may feel like every employer is reducing benefits, the results of a recent Tower Perrin survey seem to indicate otherwise.  The survey found that few respondents were planning to make dramatic changes to their benefits during the next year.  Many employers are taking this opportunity to communicate with employees about their concerns and take a harder look at their benefits strategies.  Here’s an excerpt from their press release:

“Amid worries about their 2009 performance (56% of respondents expect to see revenues decline, in some cases by as much as 20% or more), a fair number of respondents see the economic crisis as a catalyst for constructive action.  For instance:

• 70% are increasing communication to address employee concerns, and more than 57% said they were not cutting back on investments in benefit communication or education.
• 53% are trying or considering new benefit strategies they would not have considered otherwise.
• 47% reported they are taking a more holistic approach to reward management.”

The argument against making drastic cuts today is that employees tend to have long memories.  While they may not walk out your door in the current economic environment, they’ll remember how you treat them today when the environment improves.  There are certainly employers making changes to their benefits programs just to survive.  If a choice has to be made between reducing benefits and closing your doors, obviously a reduction in benefits makes more sense. 

Let’s face it -- benefits are offered as part of a total compensation package to attract and retain talented employees.  Benefits managers around the country will be faced with tough decisions this year.  Over the next 6-18 months, they’ll need to be strategic about decisions they make.  Looking for opportunities to control or cut costs will be imperative.  But employers should think twice before taking an axe to their benefits programs at will.  If they do, their employees will remember it when times aren’t quite so tough.

Editor's Note - Greg Dagley is a Benefits Consultant for a large multinational employer in Houston, TX. While his company has employees all over the globe, his job keeps him focused on US benefits and spending a lot of his time managing external vendors.  Is there any doubt his Excel skills are more advanced than yours?

Digital Medical Records - Not A Clear Winner?

Much has been said recently about the promise of portable, digital medical records, but there are two sides to the story.  For every authority that touts the efficiency, safety and cost benefits of an electronic medical record, there are others who say it's not as simple as the current administration and IT vendors would have you believe.

From BusinessWeek:

"Under the federal stimulus program enacted in February, hospitals can seek several million dollars apiece for tech purchases over the next five years. Individual physicians can receive up to $44,000. These carrots should encourage the proliferation of technology that will computerize physician orders, automate dispensing of drugs, and digitally store patient records. If providers participate broadly, those files are supposed to be accessible no matter where a consumer goes for treatment. President Barack Obama says the changes will improve care, eliminate errors, and eventually save billions of dollars a year. There's also a stick: The federal government will cut Medicare reimbursement for hospitals and medical practices that don't go electronic by 2015.

The incentives are working. R. Andrew Eckert, CEO of tech provider Eclipsys, says one client, a 250-bed hospital that shelved a software order in the fall after losing $50 million in the stock market, has reinstated the order. The move is "100% due to the stimulus," says Eckert (who won't name the hospital). Brandon Savage, chief medical officer at GE's health unit, says his company's technology will leapfrog the competition by not just replacing paper but also guiding doctors to the best, least-costly treatments."

But not everyone is sold.  It's Amercia - we like it that way: 

"That rare agreement, however, is obscuring the checkered history of computerized medical files and drowning out legitimate questions about their effectiveness. Cerner, based in Kansas City, Mo., and other industry leaders are pushing expensive systems with serious shortcomings, some doctors say. The high cost and questionable quality of products currently on the market are important reasons why barely 1 in 50 hospitals has a comprehensive electronic records system, according to a study published in March in the New England Journal of Medicine. Only 17% of physicians use any type of electronic records.

But so far there's little conclusive evidence that computerizing all of medicine will yield significant savings. And improvements to patient care may be modest. An analysis of four years of Medicare data published in March in the scholarly journal Health Affairs found only marginal improvement in patient safety due to electronic records—specifically, the avoidance of two infections a year at the average U.S. hospital. "Health IT's true value remains uncertain," wrote Stephen Parente and Jeffrey McCullough, researchers at the University of Minnesota.

Part of the problem stems from a fundamental tension. Info tech companies want to sell mass-produced software. But officials at large hospitals say such systems, once installed, require time-consuming and costly customization. The alterations often make it difficult for different hospitals and medical offices to share data—a key goal. Meantime, the health IT industry has successfully lobbied against government oversight.

"Most big health IT projects have been clear disasters," says Dr. David Kibbe, senior technology adviser to the American Academy of Family Physicians. "This [digital push] is a microcosm for health-care reform....Will the narrow special interests win out over the public good?"

What special interests you ask?  When in doubt, the cynics follow the money in D.C.  For my money, as a software firm employee, it's almost impossible to serve a market this big without some significant level of customization on a big customer basis, and as the article points out, that makes sharing data difficult.

And if we can't get a portable medical record, and it really doesn't drive safety, why would we do it?  Got to get to one standard and force it on people for the economies of scale to work.