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HIT savings stalled; report says systems need standardization

Article

Health information technology advances have failed to save the healthcare industry money because the current systems are too disconnected and difficult to use, according to a new report from Rand Corp.

Health information technology (HIT) advances have failed to save the healthcare industry money because the current systems are too disconnected and difficult to use, according to a new report from Rand Corp.

“The failure of [HIT] to quickly deliver on its promise is not caused by its lack of potential, but rather because of the shortcomings in the design of the IT systems that are currently in place,” says Art Kellerman, the senior author of the new study and holder of the Paul O’Neill Alcoa Chair in Policy Analysis at Rand, a nonprofit research organization. The study, titled “What it will take to achieve the as-yet-unfulfilled promises of health information technology,” was published in the January edition of Health Affairs.

Rand researchers predicted in 2005 that HIT could save the U.S. healthcare industry more than $81 billion per year. But 7 years later, cost savings from HIT are nowhere to be found considering that healthcare spending has grown by $800 billion.

Kellerman’s paper, co-authored by Spencer S. Jones, says that big changes are needed to increase the productivity and efficiency of HIT.

“We believe that the original promise of [HIT] can be met if the systems are redesigned to address these flaws by creating more-standardized systems that are easier to use, are truly interoperable, and afford patients more access to and control over their health data,” Kellerman and Jones write. “Providers must do their part by re-engineering care processes to take full advantage of efficiencies offered by [HIT], in the context of redesigned payment models that favor value over volume.”

The study blames a “sluggish” adoption pace, the reluctance of clinicians to devote the time and effort to learn the new systems, and the failure of healthcare systems to implement necessary process changes for holding back the progress of HIT. Additionally, current electronic health record (EHR) systems have not been designed to “talk” to one another. Kellerman and Jones compare today’s EHR systems with “frequent flyer” cards rather than the ideal “ATM cards,” because instead of providing access to patient data from anywhere at any time, the current system is intended to enforce a brand loyalty to a particular healthcare system. The information in most systems today is useless when the patient goes to another healthcare system, the authors note. 

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Jennifer N. Lee, MD, FAAFP
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