Incenting Healthcare Disparity [ was: Toward a National Rural Telehealth IT Support Policy [Update] ]

<ed.note>I noted earlier that "The American Health IT sector needs to incent less with promises of stock options and more with upfront offers of educational loan repayment. While there is federal school loan repayment help for healthcare workers ( the National Health Service Corps Loan Repayment Program ) and healthcare researchers ( the National Institutes of Health Loan Repayment Program ), there is no similar help for those healthcare IT workers who will lay the "backbone" for telehealth."

Bank of America is actually helping primary care doctors, which is laudable — although the actual need appears to me to be a lack of CYBER.NURSES. Instead of intentionally seeking a hybridization of nursing and IT ( via the NHIN related grants ), we underpay nurses and offshore HIT.</ed.note>

<ed.note>I’ve recently begun crystallizing some thoughts about the future of eHealth in the US:

There seems to be an encouraging climate emerging. First, More insurers are willing to reimburse doctors for online care ( although also see here ). Second, there are continued calls for federal employees to adopt telecommuting as a practice.

There are some important economic structure hurdles:
 
First, the way the tech economy is currently structured and incented is that nearly all resources target sales organizations {from which the C-suite execs originate — and are thus biased}. I contend that most of these C-folks will be outsourced by a national implementation of subcontract.com (or some such) sooner than they think if Walllstreet has its way. These resources reward "winning" the deal, rather than "doing" the deal; rather than toward building the skillsets of the professional services side (who actually do the technical work that provides the client’s value add). My sense is that because many of the US IT work force who were "right-sized" after the internet bubble and left the IT Sector, they cannot now realistically be expected to return to help with the eHealth build out In order for them to contribute. The American Health IT sector needs to incent less with promises of stock options and more with upfront offers of educational loan repayment. While there is federal school loan repayment help for healthcare workers ( the National Health Service Corps Loan Repayment Program ) and healthcare researchers ( the National Institutes of Health Loan Repayment Program ), there is no similar help for those healthcare IT workers who will lay the "backbone" for telehealth.

Second, it is no secret that the US IT sector demonstrates "bicoastal geographism" even as tech salaries are not keeping pace with real estate costs in those regions. At the same time, US IT firms and their healthcare customers won’t adopt telecommuting for IT staff a) at all, or b) from the American heartland; while, ironically, there seems to be little hesitation in taking some of these functions, or healthcare procedures themselves, completely offshore. The building of a managerial class which can and will manage a distributed work force seems necessary to a successful eHealth build out.

I submit that any cohesive National Rural Telehealth IT Support Policy should take these factors into consideration.</ed.note>