Ian P. McLoughlin, Karin Garrety, and Rob Wilson, The Digitalization of Healthcare: Electronic Records and the Disruption of Moral Orders (Oxford, UK: Oxford University Press, 2017). 240 pp. $90.00 (hardcover), ISBN 9780198744139

• Date: 01 January 2019
• DOI: http://doi.org/10.1111/puar.13021
• Published date: 01 January 2019

Book Reviews 141

Ian P. McLoughlin, Karin Garrety, and Rob Wilson,

The Digitalization of Healthcare: Electronic Records and the

Disruption of Moral Orders (Oxford, UK: Oxford University

Press, 2017). 240 pp. $90.00 (hardcover),

ISBN 9780198744139

Speaking in early 2009 at George Mason

University, President-Elect Barack Obama

reaffirmed the nation’s commitment to having

“all of America’s medical records computerized”

within 5 years. According to Obama, doing so would

“cut waste, eliminate red tape, and reduce the need to

repeat expensive medical tests.” Moreover, it would

“save lives by reducing the deadly but preventable

medical errors that pervade our health care system”

(NY Times 2009). That was the vision. One far

different than the reality that has ensued.

The Health Information Technology for Economic

and Clinical Health (HITECH) Act signed into

law by President Obama the month after his speech

established “meaningful use” standards. To encourage

innovation and advance implementation of a national

electronic health records (EHR) system, the legislation

stipulated that healthcare providers would receive

incentives for demonstrating meaningful use of the

technology from 2011 through 2014. The original law

stipulated further that, beginning in 2015, incentives

would be rolled back and penalties levied on providers

for noncompliance.

Evidence suggests that “meaningful use” incentives

have accelerated uptake. To date, 353,447 doctors and

4,558 hospitals have implemented electronic medical

record (EMR) keeping systems and demonstrated

at least basic transmittal capabilities (CMS 2018).

However, few would argue the program has been a

success. On the contrary, many consider it a mess

(Gallaga 2017). The law has become a source of much

rancor. Since 2009, HITECH’s original ambitious

Reviewed by: Robert S. Blake

Medical City Healthcare

Robert S. Blake is director of strategic

planning at Medical City Healthcare and a

Texas Hospital Association leadership fellow.

His research interests include decision

making, impacts of public reporting, and

healthcare consumer choice. His recent

empirical studies are published in

Review

of Public Personnel Administration

and

Medical Care Research and Review

.

E-mail: robert.blake@medicalcityhealth.com

Public Administration Review,

Vol. 79, Iss. 1, pp. 141–143. © 2019 by

The American Society for Public Administration.

DOI: 10.1111/puar.13021.