Confessions of an e-skeptic

Many are the passionate e-vangelists regarding electronic health information and its centrality to patient-centered care. "Give me my damn data," is the slogan – and I cannot disagree. I am more than happy for everyone to have access to their notes, studies, blood tests. Let everyone if they want crawl into the innards of our health care system and root around.

But the people who can use this data, or can advocate for its release, are already the empowered ones.

My doubts are these:

First, the electronic health record can actually undermine patient-centeredness, and I assume patient-available health information can do the same thing. Information is not the most important basis of communication – emotions and relationships are.

Second, health IT can improve healthcare disparities, but it could just as easily become a reflection of them, or – worse – an extension of these disparities into new areas.

E-vangelism is a species of True Belief. There are always going to be patients who, for whatever reason, cannot get with the latest technological or reform program. We should be caring for those people first, because they are the most disadvantaged, generally the sickest, and certainly those who saddle our system with great cost. Let's make mobile health a tool for the triple aim, not the other way around.