Thursday, March 19, 2009

Health Care and Health Information Technology

According to the Health & Human Services agency of the US federal government (HHS), health information technologies can be tools that help individuals maintain their health through better management of their health information. Health IT will help consumers gather all of their health information in one place so they can thoroughly understand it and share it securely with their health care providers so they get the care that best fits their individual needs. Health IT can help to improve public health one individual at a time by building partnerships between health care consumers and providers across the country.

Health information technology (Health IT), according to the HHS, allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of health IT will:
--Improve health care quality;
--Prevent medical errors;
--Reduce health care costs;
--Increase administrative efficiencies;
--Decrease paperwork; and
--Expand access to affordable care.
Interoperable health IT will improve individual patient care, but it will also bring many public health benefits including:
--Early detection of infectious disease outbreaks around the country;
--Improved tracking of chronic disease management; and
--Evaluation of health care based on value enabled by the collection of de-identified price and quality information that can be compared.

However, according to, IT industry analysts widely agree that software implementations fail because of the customers. It’s too easy to point the finger at software vendors or at the software itself, but failure usually is the buyer’s fault. In a recent survey, one group identified the following top reasons for IT implementation failures:
~40% attribute failure to poor planning and communication;
~20% cite mismanagement and rejection by end users; and
~15% blame overspending.
Very few doctors use EHRs. In fact, most predictions put EMR market penetration at 10%-15%. We all know why this figure is so low: doctors don’t want to use them, practice staff is stuck doing things “the old-fashioned way,” etc. Now that Uncle Sam is willing to pay for EMRs (and telling us we had better buy!), a lot more practices are going to adopt them. The scary thing, however, is that the same feelings that have slowed the adoption of EMRs are still prevalent. More detail is available online at about this issue and suggested steps to create a smooth, successful EMR implementation.

According to the Rand Organization, major issues exist with implementing HIT. Current market conditions place serious obstacles in the way of effective HIT implementation:
1.) Relatively few providers have access to HIT. Only about 20 to 25 percent of hospitals and 15 to 20 percent of physicians’ offices have a HIT system. Small hospitals and hospitals with half or more of their patients on Medicare are less likely to have HIT.
2.) Connectivity — the ability to share information from system to system — is poor. HIT implementation is growing, but there is little sharing of health information between existing systems. There is no market pressure to develop HIT systems that can talk to each other. The piecemeal implementation currently under way may actually create additional barriers to the development of a future standardized system because of the high costs of replacing or converting today’s non-standard systems.
3.) Finally, one of the most serious barriers is the disconnect between who pays for HIT and who profits from HIT. Patients benefit from better health, and payors benefit from lower costs; however, providers pay in both higher costs to implement HIT and lower revenues after implementation. Hospitals that use HIT to reduce adverse drug events also reduce bed-days — and reduced bed-days mean reduced hospital income.

Rand suggests that widespread adoption of HIT and related technologies, applied correctly, could greatly improve health and healthcare in America while yielding significant savings. A range of policy options could be used to speed the development of HIT benefits. They suggest that government action is needed; without such action, it may be impossible to overcome market obstacles. Their findings strongly suggest that it is time for government and other payors to aggressively promote the adoption of effective Health Information Technology. However, moving the American health care system forward to adopt HIT on a wholesale basis should be viewed primarily as a goal instead of a government mandate. Funding needs should come from both private and public resources to assist in the costs for this agenda.

According to the American Hospital Association (AHA), the work of hospitals is caring for patients. Every day America’s hospitals strive to improve the safety and quality of that care. Research has shown that certain kinds of information technology (IT) – such as computerized physician order entry (CPOE), computerized decision support systems, and bar-coding for medication administration – can limit errors and improve care. HIT also can be a tool for improving efficiency. While hospitals have been pioneers in harnessing HIT to improve patient care, quality and efficiency, the challenge now is to extend its use and integrate it into the routine care processes in all hospitals, big and small, in both rural and urban areas.

Increasingly, health information technology (HIT) is at the forefront of public and private sector efforts to improve healthcare safety, quality, and efficiency according to Clear and compelling evidence has emerged demonstrating that HIT can play a critical role in addressing the challenges faced by the U.S. healthcare system. The Federal government, a number of states, and private sector leaders at the national, state and regional level have responded with the introduction of a myriad of policies and strategies designed to improve the quality, safety and efficiency of healthcare through information technology. Congress is also playing a significant leadership role with bi-partisan support of the use of HIT to improve healthcare. The private sector has also demonstrated significant leadership with the emergence of several initiatives and programs designed to improve healthcare through HIT along with the rapid expansion in state, regional and community-based health information exchange organizations and initiatives. And, according to Science Daily, the federal government is poised to pour $19 billion into health information technology as part of the new economic stimulus package. has reported that HIT will be a primary focus in the following initiatives:
--Policy changes in the Medicare and Medicaid programs that will accelerate the adoption of HIT to address goals around healthcare quality, safety and efficiency;
--Policy goals and strategies introduced in a series of legislation introduced by Congress, and prospects and expectations of action during the remainder of the year;
--Financial incentives programs emerging in many parts of the U.S. which are sponsored by purchasers, business coalitions, health plans, and Medicare;
--Health plan, purchaser, and public sector payer experiences in leveraging HIT for chronic care and disease management programs;
--Strategies for HIT adoption utilized by state policy-makers in their role as purchaser, payer and regulator;
--Real-world experiences of leaders who are building multi-stakeholder collaborations in states, regions, and communities across the U.S. to speed adoption of HIT and health information exchange to support patient care.

According to a study by Kaiser Permanente as reported by Health Affairs, a comprehensive electronic health record can increase consumer convenience and satisfaction and provider efficiency while maintaining clinical quality, and that connecting patients directly with their care providers and giving online access to important medical information was critical in adoption of online tools. In addition to the convenience of fewer office visits and the benefits of faster resolution of health issues, e-mail messaging and scheduled telephone visits saved consumers the often overlooked out-of-pocket expenses for travel and parking, and time lost that would otherwise be spent at work or other pursuits. And, according to Science Daily, if implemented correctly, information technology (IT) systems -- including electronic health records -- have the potential to improve quality of care, increase efficiency and cost savings, reduce medical errors, and enhance continuity of care.

HIT is the wave of the future in medicine, but needs to be in place now. As more health care providers gear up for implementation, and the medical community moves toward using technology to reduce costs and improve the quality of care, consumers will benefit by experiencing lower costs and improved health care. Providers in the health care world will see better efficiencies and reduced liability, and insurance companies will experience more profitability as the cost to treat patients is reduced by decreased utilization and limiting unnecessary expenses. Although paper records will always be part of the equation, HIT will help eliminate the overabundance of duplicated hard copy files.

Until next time. Let me know what you think.


Tony Raz said...

Being a malpractice lawyer I found this article to be very informative. Help is out there and it’s easier to find if you know what you’re looking for.

brian7 said...

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