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The history of health care IT has not, in general, been a happy one. The industry has consistently underinvested in IT, and thanks to the ongoing misalignment of interests among the patients, providers and payors, it doesnt look as if increased pooling of efforts and more IT investment will happen any time soon.
Still, there are pockets of health in the health care landscape. Individual hospitals, as well as some insurers, continue to press for change in the use of IT so they can do their jobs better. One example is Montefiore Medical Center in the New York City borough of the Bronx. In keeping with its 15-year effort to expand from its stand-alone hospital base to integrate more hospitals and community-based ambulatory care units, Montefiore has embarked on a major effort to create clinical systems that combine single patient records, prescription order entry, and other elements that are tightly woven into the clinicians workflow.
The team leading the hospitals IT effort includes Dr. Steven Safyer, senior vice president and chief medical officer; Jack Wolf, chief information officer; and Dr. Gary Kalkut, vice president and medical director. Editor Edward Baker spoke to the trio at their offices in the Bronx about the technological, political and cultural challenges of health care IT. An edited version of the conversation follows.