Bringing Medicine Online"The Dubious Promise of Digital Medicine" (In Depth, May 4) focused on the companies scrambling for some $20 billion in stimulus funds aimed at computerizing health records--and the serious shortcomings of some of this pricey software. Readers had some challenging questions. What about health-care staffs who are resistant to change? Or shortsighted bureaucrats? Others emphasized the benefits many expect to see if medicine goes paperless. —Chad Terhune
The media has mindlessly promoted health IT without looking critically at how difficult it is to build systems that are safe, secure, and private. Many vendors, slow to address problems, contractually require purchasers/users not to air complaints or problems in public, risking patients' lives. Some vendors "own" or can use and sell sensitive personal records without informed consent or even notice.
Dr. Deborah PeelFounderPatient Privacy RightsAUSTIN, TEX.
While the issues and risks described are real, we at Seattle Children's Hospital have made strides in patient safety that would not have been possible without our electronic health records. These include reductions in mortality, in bloodstream infections, in time elapsed from order to medication administration, and in pharmacy-ordering errors. We've also made much greater use of evidence-based treatments, decreasing the use of unwarranted therapies in specific populations. None of these changes were attainable with our old paper-based record system.
Dr. Mark Del Beccaro Chief Medical Information OfficerSeattle Children's Hospital
For tech vendors, health-care staffs are the most difficult to work with. They are the most backward in terms of computer literacy and they keep changing system requirements just before implementation.
Some blame lies with vendors who don't accurately portray how their systems fall short of a health institution's requirements, [leading to] costly customizations.
Screen name: jonathanWhere There's Smoke, There's Philip MorrisRegarding "Philip Morris Unbound" (In Depth, May 4): What's the difference between a street pusher and Philip Morris (PM) International CEO Louis Camilleri, who is "racing" to get overseas kids hooked on Marlboros? Camilleri's assertion that he's not wooing new smokers, "just encouraging existing ones to switch to higher-quality cigarettes," is transparently false, especially given PMI's Indonesian marketing campaign, aimed at teens.
Jack BlantonLEXINGTON, KY.What Bob Nardelli Did RightAlthough "Bob Nardelli's Wrong Turns" (News, May 4) doesn't mention a single accomplishment, Nardelli has achieved much in 21 months at the helm of Chrysler.
He and his talented team have improved quality, created a more competitive cost structure, strengthened dealer relations, and reduced capacity and inventories to maximize the company's assets.
Chrysler has also continued to develop products for the future, including an impressive lineup of electric vehicles. Bob Nardelli has been a true professional in the most difficult of circumstances.
Roger PenskePenske CorporationDETROIT
Penske Racing, which has a Nascar contract with Chrysler, won the 2008 Daytona 500 with a Dodge stock car.The Economic Crisis: A Prescription from the Austrian SchoolRegarding "What Good Are Economists Anyway?" (Cover Story, Apr. 27): A significant body of economists did predict the current crisis: Austrian School economists. We saw this coming for a long time. And we have the answer, too: abolishing the Fed, instituting a sound-money (gold standard) policy, and limiting the government's role.
Patrick BarronWEST CHESTER, PA.