Health Information Technology

Linkages to IOM Six Aims

Patient Centered —provides meaningful, understandable and useful information for patients and providers at the point of care. An aid in coordinating care between different providers.

Efficient —more complete, timely and relevant patient-focused data and clinical decision support tools available in a secure manner to both clinicians and patients as part of the workflow at the point of care.

Safe —provides comprehensive patient information in a centralized manner.

Business Case

HIT will significantly reduce health care costs by improving communication and efficiencies. The Commonwealth Fund report, Bending the Curve , put the aggregate system-wide savings of promoting health information technology at $88 billion over 10 years. In this report, it is estimated that the cost reductions would result from a lower rate of medical errors, more efficient use of diagnostic testing, more effective drug utilization, and decreased provider costs, among other improvements. In addition, savings would likely be achieved from better care coordination among multiple providers—and improved chronic care management—that would lead to a decrease in provider utilization and better health outcomes. Financial benefits accrue to all payers, with investments in HIT estimated to result in substantial cumulative net savings to all levels of government and households over 10 years and cumulative savings to private insurers after 11 years. [ii]

Furthermore, personal health records (PHRs), which let individuals maintain their own information in a portable platform, will also give patients a greater stake in their own care. In a recent study published in Health Affairs examining the Kaiser Permanente HIT system, researchers demonstrated patients' willingness to manage their health care online. Web site activity among Kaiser patients between 2004 and 2007 showed that there is a real potential for better results by getting patients more involved in their own health care through EHRs and PHRs. In 2004, 10.7 million people visited the site. By 2007, site visits had tripled to 33 million. [iii]

More actively involved patients, coupled with better-informed doctors communicating with one another, can reduce the number of expensive office visits. According to another study of the Kaiser system, Kaiser Permanente Hawaii saw a 26.2 percent decrease in office visits in the three years after implementing a comprehensive HIT system. Patients became far more likely to rely on cheaper and faster e-mail and phone consultations, facilitated by the fact that their doctors had electronic access to all of the patient information. Applied broadly, this kind of change could generate enormous cost savings in a $413 billion program like Medicare, which has over 40 million enrollees. [iv]

Health Care Reform/Regulatory/Policy Considerations

Health Information Technology for Economic and Clinical Health Act or HITECH Act
Lawmakers incorporated the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the American Recovery and Reinvestment Act of 2009 (H.R. 1), the economic stimulus bill that the President signed into law on February 17, 2009 (P.L. 111-5). The HITECH Act is intended to promote the widespread adoption of health information technology (HIT) to support the electronic sharing of clinical data among hospitals, physicians, and other health care stakeholders.

This bill establishes four major goals that advance the use of health information technology (Health IT), such as electronic health records by:

• Requiring the government to take a leadership role to develop standards by 2010 that allow for the nationwide electronic exchange and use of health information to improve quality and coordination of care.
• Investing $20 billion in health information technology infrastructure and Medicare and Medicaid incentives to encourage doctors and hospitals to use HIT to electronically exchange patients’ health information.
• Saving the government $10 billion, and generating additional savings throughout the health sector, through improvements in quality of care and care coordination, and reductions in medical errors and duplicative care.   
• Strengthening Federal privacy and security law to protect identifiable health information from misuse as the health care sector increases use of Health IT.

As a result of this legislation, the Congressional Budget Office estimates that approximately 90 percent of doctors and 70 percent of hospitals will be using comprehensive electronic health records within the next decade. [v] 

Linkages to Performance Excellence

Perfect the patient experience—having relevant information at the point of care will increase quality of care patient receive

Remove waste—Streamlining processes will eliminate unnecessary steps

Reduce process variation—HIT promotes consistency and error reduction by automating processes.