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Arguably, just about everyone believes information technology will save the healthcare industry republic from its own inefficiency. Those include policy wonks, political candidates, pundits, healthcare administrators, clinicians and related staffers, software vendors and a receptive public. But as IT promoters and purveyors try to prop it up as a monarch on a par with self-deified physicians they’re facing considerable skepticism and tension from the players in the Senate that seem to rule the industry and control the public’s journey through the healthcare system – payers and providers.

And the one key act of betrayal preventing IT’s ascent to greatness comes from its closest friend – funding. After all, software research and development costs money. Payers and providers have to buy the software, which costs money. Then they have to implement the software, which requires disruptive behavioral and process changes … and therefore costs money. At least for a little while.

At some point, it should start saving money, but the industry first has to endure the pain of going on an efficiency diet. Most 21st Century Americans want to avoid three things: Accountability, inconvenience (waiting more than 10 seconds for optimal results) and responsibility. Much to our chagrin, there’s no magic pill or genie-in-a-bottle to help us lose weight; neither is there an "iManual" that equips us to hit the reset button to instantly make healthcare management more efficient.

President Bush acutely recruited David Brailer, Ph.D., to be his healthcare IT guy, the champion of promoting truth, justice and implementation around the industry. Before he bolted for the more lucrative private sector for whatever reason Brailer succeeded in marshaling a marketing blitz that seduced a wanton media looking for a computer-related rebound topic after licking its wounds from the dot-com bomb. He also managed to inspire one constituency within healthcare and irritate the other.

Don’t get me wrong: Brailer clearly infused and energized the healthcare industry as a more diplomatic, sophisticated and tactful Dr. Phil. If anything, Brailer is to healthcare IT what Alan Greenspan was to the Federal Reserve. What’s telling is that both are several years removed from their respective posts, but many probably will struggle to name their successors without Googling. (For the record, they are Robert Kolodner and Ben Bernanke.) Hopefully, it’s not the healthcare industry’s way of adapting the "Sex and The City" passing fad, "we’re just not that into you anymore," thanks to the seemingly dragging progress.

Case in point: Brailer continues to generate headlines – conveniently on the eve of the annual Healthcare Information and Management Systems Society (HIMSS) meeting later this month – declaring that 2008 will usher in only "incremental" change and not "transformational" change. Meanwhile, Kolodner reported that his federal health IT office won’t be receiving any funding bumps this year to pull off Bush’s Nationwide Health Information Network by 2014. Hmmm…which viewpoint might attract the interests of headline-grabbing media outlets?

Regional health information organization (RHIO) projects are floundering, if not dissolving. Survey after survey of people in healthcare show that most believe nothing will change because of limited or lack of funding. Even the presidential candidates tout healthcare IT as a panacea but don’t provide any realistic or actionable details on how to pay for it – and who’s going to pay for it. (For the record again, that’s you and me.)

But healthcare’s Brutus is just a ploy, if not an excuse, to keep Julius Caesar at bay in a battle of Shakespearian comedic and tragic proportions.

Healthcare IT products absolutely can revolutionize the industry from an efficiency standpoint in the same way the calculator revolutionized mathematical education. The difference? There’s only one way to add, subtract, multiply and divide (unless some new math principles have invaded scholarly thinking).

Healthcare can only dream of a single standard agreed upon, adopted and implemented universally by all segments of the industry. It’s a major hurdle the size of Mount Vesuvius. No one really wants to throw money away to make any meaningful changes until egos are suppressed, greed is sated and selfish agendas are shelved in favor of reaching a consensus for the good of an industry and the public it supposedly wants to serve. To do nothing but debate and pontificate, study and analyze without taking any risky steps forward will lead to a violent financial and operational eruption that may equal, if not overshadow, the aftermath of a pandemic. Until that level of enlightenment and maturity is attained, we’re stuck in the Dark Ages scrambling for green to stanch the fiscal bleeding.