Like it or not, spending the public’s money on the HIT transition is a Catch-22.

On the one hand, billions of dollars are being spent on a promise. On the other hand, there’s no way of knowing for sure whether the promise will come true until those billions are spent.

There are, of course, many reasons to believe we’re heading in the right direction, but skepticism remains, and skeptics seem to be getting a little help from researchers.

According to this article, “more and more studies are questioning the efficacy of electronic health records, and the U.S. Food and Drug Administration has begun collecting reports involving electronic health and IT errors, some of which have resulted in death.”

Despite the temptation, at least on the part of HIT’s most dedicated proponents, to greet less-than-favorable studies with a chorus of “Yes, but . . .”, we’re inclined to think that some negative reviews early in the transition might not be a bad thing.

For one thing, assuming policymakers can remain flexible and responsive to new information, they have the opportunity to adjust or re-direct the programs they’ve put in place. Perhaps more importantly, they can also identify holes in existing programs and, ideally, figure out ways to make them better.

For example, to our eyes the key assertion in this article comes from a medical IT expert and academic. "Health information technology can meet the goals that are talked about,” he says. "But only if done well. And the amount of complexity behind that simple phrase -- 'if done well' -- is enormous and largely unrecognized and ignored."

Which leads us to perhaps the other big Catch-22 at play, here. Like it or not, politics is often an exercise in necessary, often even absurd, simplification. Which leads, perhaps, to some of the “irrational exuberance” often found in HIT’s most enthusiastic supporters.

But the world of HIT, in particular making sure HIT is “done well,” is anything but simple.