DOT. G B EYOND THEIR SHARED BELIEF in the power of IT to transform health care. what unites Brailer. McClellan, and Frist is the fact that all three started out not as policy wonks or politicians, but as doctors. all three can tell their own stories about patients like Joe Wilson, who die unnecessarily every ear not because of human error, but because of system error. Indeed, Joe Wilson preventable death is not the fault of any individual actor or institution, but of an entire system in which those individuals are merely seeking to survive and thrive This glib abdication should give us no comfort. Rather, it can just as easily be said that these deaths are the fault of all of us The author gratefully acknowledges the assistance, advice, and encouragement of Genevieve Bell,Joshua Blum Colin Evans, Miles Hochstein, Michelle Lee, Josh Lemieux, and Regis McDonald in the development of this paper. NOTES 1. All prescribing information is from the 2005 Physicians Desk Reference(New York: Medical Economics Pub lishing, 2004) 2. The U.S. personal financial services industry accounts for 8-10 percent of gross domestic product(GDP) Trust Me, I'm a Banker, Economist( 15 April 2004): 21 3. See, for example, M. Friedman, A Program for Monetary Stability(New York: Fordham University Press, 1960): E von Hayek, The Road to Serfdom(New York: Routledge, 1944); and R.M. Ebeling, "Monetary Cen- tral Planning and the State, Part 24: Milton Friedman's Framework for Economic Stability, " Freedom Daily December1998,www.fff.org/freedom/1298b.asp(20July2005) ]. Taylor, Principles of Economics, 3d ed ( Palo Alto, Calif: Stanford University Press, 2001) 5. JD. Kleinke, Oxymorons: The Mythofa US. Health Care System(San Francisco: Jossey-Bass, 200) 6. B. Donald, "Newt Gingrich Pushing"Wired Hospitals, "Associated Press, 22 June 2004 7. President G W. Bush, State of the Union Address, 2 February 2005, wwwwhitehouse gow/news/releases/ 2005/02/ print/20050202html(20Jly2005) 8. See"Bugs and Viruses, "Economist(28 February 1998): 66-68: N Gingrich and P. Kennedy, "Operating in cuum, "New York Times, 3 May 2004; "Medical Paper-Pushers Resist Opportunity to Improve Care, us day 13 May 2004, and M. Siegel. "Bill Frist, Bioterrorism, and Visits to the Doctor, "Nation, 9 January 2003,www.thenation.com/doc.mhtml?i2003127&s-marc20030109(20jUly2005) 9. Newt Gingrich, Center for Health Transformation, keynote speech, 2004 Managed Healthcare Sympo. um, Dana Point California, November 2004 10. M. Baker,"Report: Pay Physicians to Connect,"Eweek, 29 October 2004: J. Carroll, "Electronic Medical Records. High Hopes Meet Harsh Reality,"Managed Care 13, no 11(2004): 14; and Mark McClellan, CMS, address to Executives Club of Chicago, 16 February 2005 l1. Leapfrog's measures of hospital quality include the installation of computerized physician order entr (CPOE)systems, which cost on average $3-$10 million depending on hospital size and level of existing IT infrastructure. See E Poon et al, "Overcoming Barriers to Adopting and Implementing Computerized Physician Order Entry Systems in U.S. Hospitals, "Health Affairs 23, no. 4(2004): 184-190 12.JD. Kleinke, "Vaporware. com: The Failed Promise of the Health Care Internet, Health Afairs 19, no. 6 (2000):57-7 13.HealthDataManagement"fEdSetsClaimsPaymentRules,"21November2000,www.healthdata anagement. com/html/egRegStory cfm? DID- 2170(5 March 2005); and L McGinley, "Company Health Plans Have Less Time to Respond to Patients' Claims, Appeals, " Wall Street Journal, 21 Nove 4 R. Cunningham, "Professionalism Reconsidered: Physician Payment in a Small-Practice Environment, Health Affairs 23, no 6(2004): 36-47; and] Jacob, "Fee for Service Rebounding as Insurers Rethink Capita- tion, "American Medical News, 22/29 May 2000, 1. 15. J. Walker et al, "The Value of Health Care Information Exchange and Interoperability, " Health Affairs, 19 January 2005, content. healthaffairs org/cgi/content/abstract/hlthaf w 5.10(7 June 2005) HEALTH AFFAIRS 1261D o T - G o V B EYOND THEIR SHARED BELIEF in the power of IT to transform health care, what unites Brailer, McClellan, and Frist is the fact that all three started out not as policy wonks or politicians, but as doctors. All three can tell their own stories about patients like Joe Wilson, who die unnecessarily every year not because of human error, but because of system error. Indeed, Joe Wilson's preventable death is not the fault of any individual actor or institution, but of an entire system in which those individuals are merely seeking to survive and thrive. This glib abdication should give us no comfort. Rather, it can just as easily be said that these deaths are the fault of all of us. The author gratefully acknowledges the assistance, advice, and encouragement ofGenevieve Bell,]oshua Blum, Colin Evans, Miles Hochstein, Michelle Lee, ]osh Lemieux, and Regis McDonald in the development of this paper. NOTES 1. All prescribing information is from the 2005 Physicians Desk Reference (New York; Medical Economics Pub￾lishing, 2004). 2. The U.S. personal financial services industry accounts for 8-10 percent of gross domestic product (GDP). "Trust Me, I'm a Banker," Economist (15 April 2004): 21. 3. See, for example, M. Friedman, A Program for Monetary Stability (New York Fordham University Press, 1960); F. von Hayek, The Road to Serfdom (New York Routledge, 1944); and R.M. Ebeling, "Monetary Cen￾tral Planning and the State, Part 24: Milton Friedman's Framework for Economic Stability," Freedom Daily, December 1998, www.fff.org/freedom/1298b.asp (20 July 2005). 4. J. Taylor, Principles of Economics, 3d ed (Palo Alto, Calif.: Stanford University Press, 2001). 5. J.D. Kleinke, Oxymorons: The Myth ofa U.S. Health CareSystem (San Francisco: Jossey-Bass, 2001). 6. B. Donald, "Newt Gingrich Pushing 'Wired' Hospitals," Associated Press, 22 June 2004. 7. President G.W. Bush, State of the Union Address, 2 February 2005, wwwwhitehouse.gov/news/releases/ 2005/02/print/20050202-lLhtinl (20 July 2005). 8. See "Bugs and Viruses," Economist (28 February 1998): 66-68; N. Gingrich and P Kennedy, "Operating in a Vacuum," New York Times, 3 May 2004; "Medical Paper-Pushers Resist Opportunity to Improve Care," USA Today, 13 May 2004; and M. Siegel, "BiU Frist, Bioterrorism, and Visits to the Doctor," Nation, 9 January 2003, www.thenation.com/doc.mhtml?i-2003127&s=marc20030109 (20 July 2005). 9. Newt Gingrich, Center for Health Transformation, keynote speech, 2004 Managed Healthcare Sympo￾sium, Dana Point, California, November 2004. 10. M. Baker, "Report: Pay Physicians to Connect," Eweefe, 29 October 2004; J. CarroU, "Electronic Medical Records: High Hopes Meet Harsh Reality," Managed Care 13, no. 11 (2004): 14; and Mark McClellan, CMS, address to Executives Club of Chicago, 16 February 2005. 11. Leapfrog's measures of hospital quality include the installation of computerized physician order entry (CPOE) systems, which cost on average $3-$10 million depending on hospital size and level of existing IT infrastructure. See E. Poon et al., "Overcoming Barriers to Adopting and Implementing Computerized Physician Order Entry Systems in U.S. Hospitals," Health Affairs 23, no. 4 (2004): 184-190. 12. J.D. Kleinke, "Vaporware.com: The Failed Promise of the Health Care Internet," Health Affairs 19, no. 6 (2000): 57-71. 13. Health Data Management, "Fed Sets Claims Payment Rules," 21 November 2000, www.healthdata management.com/htniiyLegRegStory.cfm?DID-2170 (5 March 2005); and L. McGinley, "Company Health Plans Have Less Time to Respond to Patients' Claims, Appeals," WcAl Street Journal, 21 November 2000. 14. R. Cunningham, "Professionalism Reconsidered: Physician Payment in a Small-Practice Environment," Health Affairs 23, no. 6 (2004): 36-47; and J.Jacob, "Fee for Service Rebounding as Insurers Rethink Capita￾tion," American Medical News, 22/29 May 2000,1. 15. J. Walker et al., "The Value of Health Care Information Exchange and Interoperability," Health Affairs, 19 January 2005, content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.10 (7 June 2005). HEALTH AFFAIRS - Volume 24. Number 5 1261