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How to craft the perfect health IT that delivers for physicians and patients


The technology is hurting the one group it's supposed to help-doctors.

Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Glen Stream, MD, FAAFP, MBI, a family physician practicing in La Quinta, California, who is also past president of the American Academy of Family Physicians. He serves as the president and board chair of Family Medicine for America’s Health. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.


While a far cry from the health information technology available today, European doctors in the 1800s adopted the technology of their day-rudimentary tools like scalpels, probes and a revolutionary device invented by a French physician in 1816: a wooden tube that doctors used to listen and diagnose heart and lung diseases. It’s called a stethoscope.


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Just as the first stethoscope marked a major step in the ability to diagnose disease, today’s health information technology has the potential to improve the health of patients, the quality of care they receive and motivate individuals to engage more in controlling their own health and well-being.

Glen Stream, MD

But despite the potential, health IT has yet to deliver fully on its promise, falling short of supporting a healthcare system in a way that is sustainable and that can play a central role in improving the health of the U.S. population.


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Policymakers agree on the need to overhaul the country’s underperforming healthcare system to deliver on the “Triple Aim” of better health, better quality and better value. But, according to a recent report by Family Medicine for America’s Health, a coalition of the nation’s eight leading family medicine organizations, rather than being a catalyst to “foster connections and relationships among health care professionals, individuals and communities,” health IT frequently serves as a “barrier” to achieving those goals.

It’s also hurting one group it’s supposed to help-doctors.

Next: So what can be done?


“The poor usability and utility,” the report found, “is resulting in health IT contributing to the growing problem of physician burnout.” This is a pressing concern given that the country faces an imminent shortage of primary care physicians and a growing demand for primary care services that the Congressional Budget Office projects will have increased by 18 percent between 2013 and 2023.


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What’s needed is what the coalition calls a “principled redesign” of health IT that would embrace new types of information and new kinds of technology to enhance the ability of primary care doctors and their teams-the professionals best-situated to achieve the Triple Aim goals-to improve healthcare and the health of patients.

The report sets forth a vision that foresees that within ten years, technology will play an increasingly important role in making it easier for individuals and their healthcare professionals to have “a comprehensive view” of a patient health, which will enable the development and execution of personalized care plans.

To deliver on health IT’s promise, the coalition says the nation must close the technology gap, setting out a list of fifteen expectations for IT improvement. For example, under the vision statement, within a year, technologies will emerge to remove barriers to patient-doctor communication, creating greater connection, transparency and trust.

In three years, technology will be available to allow everyone in the country to have their own health records. Technology will also provide easy ways to support healthy behaviors like diet and exercise.


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In five years, technology will aggregate data to meaningfully compute health indicators to enable early identification of emerging health problems. In seven years, technology will help bridge gaps in care and reduce disparities in care that have a negative impact on the health of the poor and members of certain racial, ethnic and socioeconomic groups.

Next: Still have a long way to go


And in 10 years, the family medicine coalition envisions technology that will fully support the role of primary care doctors as leaders, partners and advocates for the health of all.


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Congress in 2009 passed legislation aimed at accelerating the use of health IT by making available up to $27 billion in incentive payments to hospitals and health professionals to encourage them to adopt and use electronic health records. A year later, the newly established Center for Medicare & Medicaid Innovation began testing new payment and care delivery models that required the use of information technology to coordinate care.  

While these and other efforts may represent positive advancements in health IT, we still have a long way to go before the benefits of technology are fully realized. That won’t happen until there’s IT in place and in wide use that strengthens the patient-physician relationship, promotes collaboration across the medical neighborhood and allows patients to have greater control of their own health.   


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Glen R. Stream, MD, is a family physician in La Quinta, California, and president of Family Medicine for America’s Health, which sponsors Health is Primary. Steven E. Waldren, MD, is director, Alliance for eHealth Innovation at the American Academy of Family Physicians and leader of the Family Medicine for America’s Health Technology Tactic Team.

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