Incorporating health IT solutions to “fix” a troublesome healthcare system has long been touted as the backbone of healthcare reform. Health IT would not only greatly improve the delivery of care through increased performance, it could also largely pay for itself by introducing previously unheard of efficiencies.
A much cited RAND Corporation study in 2005 projected that rapid adoption of health IT solutions could save the United States more than $81 billion annually—savings that would help underwrite the government’s investment in health IT through the HITECH act, which provided financial incentives for the adoption of the electronic medical record (EMR).However, a recently released RAND study now presents a rather grim assessment of the current state of health IT. Despite wide investments nationally in EMRs and related tools, the cost-saving promise of health IT has still not been realized. Systems that are currently in place are neither interconnected nor easy to use.
This is discouraging news, especially when coupled with the announcement this month that Medicare and Medicaid electronic health record (EHR) payments are estimated to have spent $10.3 billion on physicians and hospitals from the program’s inception through December 2012. National Coordinator for Health IT, Farzad Mostashari, has stated that there is no set limit for how much the federal government can spend on rewarding providers who adopt and use EHRs under the meaningful use EHR incentive program. The federal government estimates it will pay out around $20 billion in incentives before the program ends.
So is all this investment amounting to no return? In some sense, it doesn’t matter; the EHR is a reality and here to stay. Returning to a paper system is not an option. While everyone may experience some dissatisfaction with the implementation of health IT, it remains backed by government incentives and commercial demand, and it will continue to grow. It is better to insist now on obtaining systems that provide true value rather than questioning the choice to underwrite health IT adoption in the first place.
The fixes that the RAND report offers are such common sense that spelling them out seems almost redundant:
- Information should be immediately and easily accessible to all providers giving care, no matter their location—especially in emergency situations.
- That same information should be immediately and easily accessible to the patients themselves. Patient involvement requires that the actual patient be able to quickly find their own personal health information, just as every citizen can currently check private bank balances or credit card accounts. It must be that easy.
- Systems need to be easy to use. Healthcare providers should not require extensive training to get up to speed on using new systems. In this day and age, creating logical, intuitive health IT systems should be a given.
Interoperability of patient data between hospitals and health care systems should remain the highest priority of any EHR system. This is a standard that can be reached, and reached in a fashion that does not force providers to spend more time interacting with the system than they do providing care for patients. These are attainable goals, and while it may be disappointing to realize it is not yet the standard, the industry as a whole can continue to work to make this vision a common reality.