Is Health Information Technology a Boon or a Boondoggle?

Depending upon who is asked, health information technology (HIT) is a powerful aid, an unfulfilled promise or an enormous drain on the nation's health care resources. While most of the medical community has responded with frustration and outright refusal to the government's legislative mandates to implement HIT throughout the industry, there is still ongoing debate whether this technology is currently viable.

One of the cornerstones of the government's Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and the Affordable Care Act of 2010 was a 2005 study by the RAND Corporation that found the country could save $81 billion if electronic health records were introduced throughout the industry. The study used computer modeling to determine the likely benefits if 90 percent of physicians and hospitals adopted HIT.

Unfortunately, the RAND study was later debunked by the company itself.  The RAND Corporation publicly admitted that its study incorporated weak research designs and unreliable data to reach unsupportable conclusions.  The company also admitted that the project was funded by large HIT vendors.

In the wake of the initial study, more than 30,000 subsequent investigations into the benefits of HIT have found few links between the nascent technology and improved efficiency in medical care delivery. Most of these studies showed negligible improvements in health care organizations that used electronic medical records.

While HIT has been touted as a way to standardize medical data across departments and organizations, the vast majority of care providers have found that the lack of uniformity among HIT vendors makes much of the system unworkable.  However, physician dissatisfaction has been ebbing in recent years. According to a study by Medical Economics, almost 55 percent of doctors are very or fairly satisfied with electronic health records.  Almost 45 percent of physicians report that their practices have financially benefited from the use EHR's. Four fifths of all physician respondents reported that they were currently using EHR's.

While these numbers don't indicate a sea change in the industry, it may suggest that more practices are using minimal EHR systems to comply with governmental mandates. There is still a substantial minority of doctors who vehemently oppose HIT.  A study conducted by AmericanEHR found that 72 percent of 940 polled physicians found EHR's kept their workloads at a similar level or increased it. Forty-three percent reported that implementation of HIT had diminished productivity.  

This latest study found that there were two EHR systems that physicians found satisfactory: Practice Fusion and e-MDs Solutions, but there was little variation in the industry. Almost 70 percent of physicians employed one of ten EHR systems. Among the most popular systems were EpicCare Ambulatory EMR, Allscripts and NextGen Ambulatory which had dissatisfaction ratings from 50 to 75 percent.

There is a more complex issue that undergirds the entire HIT debate: are organizations using health information technology in a way that optimizes efficiency? Plenty of groups have complied with the law without fully utilizing the functionality of these new systems.  The climbing satisfaction scores among HIT-enabled organizations as they age suggest that increased familiarity does facilitate better care.  As the industry moves into the final stage of Meaningful Use which emphasizes interoperability, it should be expected that there will again be some push back, but there should be more optimism that these technological platforms are benefiting patients and their providers. 

Article written by:

Robert Moghim, M.D.

CEO, Health Carousel Locum Tenens