Health Information Technology—Results From a Roundtable Discussion

Abstract

H ealth information technology (HIT), the secure transmission and management of health information, is relatively new. Despite its availability, acceptance and use of HIT in the United States has been slow and lags behind many industrialized countries.1 Forces within the current environment-rising health care expenditures, high adverse event rates, and government and private initiatives-are increasing the speed of acceptance of HIT. Challenges to the adoption of HIT in the United States have included the high costs of the technology, general resistance to change, misaligned incentives, and the fractured payment system. Believing that HIT will improve the quality and safety of health care, President George W. Bush set a goal for most Americans to have an electronic health record (EHR) by 2014.2 The Centers for Medicare & Medicaid Services (CMS) has followed through on this directive by instituting programs aimed at increasing the adoption and use of HIT, starting with e-prescribing and EHR.■■ Benefits of HIT Increased use of HIT can benefit all members of the health care system: patients, payers, prescribers, physicians, office staff, and pharmacies.3 While one particular technology may provide a more apparent benefit to a particular segment, the overall improvement in patient care that can be realized affects all stakeholders in the process. Improvements in Quality of CareData drive the measurement of quality in health care. Collecting data can be cumbersome in a paper and pencil world. Capturing information electronically is a major asset of HIT and facilitates quality measurement. Data that are mined through HIT applications provide continuous feedback to providers and plans and are an invaluable tool for guiding future care decisions.E-prescribing E-prescribing uses technology to allow prescribers to electronically transmit prescriptions. The intent of this technology is to reduce medication errors and improve patient care by eliminating the need for interpreting handwritten prescriptions. 4 Through the increased use of e-prescribing, physicians have the benefit of receiving real-time formulary, drug-drug and drugallergy information as well as a history of drugs dispensed for the patient. The elimination of handwriting interpretation decreases medication error rates and reduces communication time between pharmacies and office staff. Payers are better able to promote increased utilization of generic and preferred brand drugs, as well as avoid costs resulting from adverse drug events. However, , notably e-prescribing and electronic health records (EHR), have the potential to improve the quality of care, reduce medication errors and adverse events, and decrease overall health care utilization and costs. However, the United States continues to lag behind other countries in the adoption and use of HIT.OBJECTIVE: To review the various issues surrounding the implementation of HIT in the United States and potential drivers that will influence the use of e-prescribing and EHR.SUMMARY: The United States has been slow t...

Adoption and use of health information technology in physician practice organisations: systematic review

“…3,4 With the upfront cost of purchasing and installing an electronic system ranging from $15 000 to $50 000 per physician, it is not surprising that 55% of physicians surveyed by the Medical Records Institute cited lack of adequate funding as the primary barrier to adopting HIT in their practices. 1,5 Supporting this statistic are findings from seven recent physician surveys on the adoption and utilisation of HIT within physician practices; between 60% and 85% of these physicians cited the initial and ongoing costs of technology purchase and implementation as the single most important barrier to adoption.…”

“…Concerns about the privacy and confidentiality of patient information stored and accessed within an electronic system remain obstacles to EMR implementation. 1,3,17,50,56,64 A 2006 survey of paediatricians noted that practitioners were apprehensive about maintaining patient privacy within an EMR system, and expressed reluctance to share the possibility of HIT utilisation with patients in their practices. 15 Findings from ten physician focus groups also highlight concerns about the technical capabilities and overall 'fit' of HIT to physician group environments.…”

Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review

“…1,2 Professional resistance to new technologies is cited as a major barrier to progress, although evidence for such assertions is weak. 3 Implementing and embedding new technologies of any kind involves complex processes of change at the micro level for professionals and patients and at the meso level for health-care organizations themselves. The European Union has recently argued that implementing e-health strategies "has almost everywhere proven to be much more complex and time-consuming than initially anticipated".…”

Lack of Association Between Electronic Health Record Systems and Improvement in Use of Evidence‐Based Heart Failure Therapies in Outpatient Cardiology Practices

“…1,2 The Institute of Medicine has strongly advocated EHR use to improve healthcare quality, and the Health Information Technology for Economic and Clinical Health (HITECH) provisions of the American Reinvestment and Recovery Act of 2009 are providing for large financial incentives and penalties to encourage adoption of EHR. 3,4 However, studies evaluating the effectiveness of EHR in improving the quality of patient care have yielded mixed results, particularly in the outpatient setting.…”