Strategies and Technologies for Healthcare Information: Theory into Practice (Health Informatics)

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Key Findings

Better information systems could help. Other industries have lowered costs and improved quality through heavy investments in information technology. Could healthcare achieve similar results? The team also has identified the actions needed to turn potential benefits into actual benefits. The RAND team drew upon data from a number of sources, including surveys, publications, interviews, and an expert-panel review. The team also analyzed the costs and benefits of information technology in other industries, paying special attention to the factors that enable such technology to succeed.

Strategies and Technologies for Healthcare Information : Theory into Practice

The team then prepared mathematical models to estimate the costs and benefits of HIT implementation in healthcare. HIT systems provide timely access to patient information and if standardized and networked can communicate health information to other providers, patients, and insurers.

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Creating and maintaining such systems is complex. However, the benefits can include dramatic efficiency savings, greatly increased safety, and health benefits. Efficiency savings result when the same work is performed with fewer resources. Increased safety results largely from the alerts and reminders generated by Computerized Physician Order Entry systems for medications. Most of the savings would be generated by hospitals with more than beds. Patients age 65 or older would account for the majority of avoided adverse drug events. The team analyzed two kinds of interventions intended to enhance health: disease prevention and chronic-disease management.

Health Information Technology

HIT helps with prevention by scanning patient records for risk factors and by recommending appropriate preventive services, such as vaccinations and screenings. The table shows the estimated effects of increasing five preventive services: two types of vaccination and three types of screening. Together, these measures would modestly increase healthcare expenditures. But the costs are not large, and the health benefits of improved prevention are significant. HIT can also facilitate chronic-disease management.

Health informatics - Wikipedia

The HIT system can help identify patients in need of tests or other services, and it can ensure consistent recording of results. Patients using remote monitoring systems could transmit their vital signs directly from their homes to their providers, allowing a quick response to potential problems. While the task is still daunting, we can all be encouraged by progress being made in information management.

There are documented successes throughout health care, and there is growing recognition by healthcare chief executive officers and boards that information strategies, and their deployment, are essential to organizational efficiency, quite pos sibly organizational survival. Data Warehouses and Clinical Data Repositories. Internet Technologies. Information System Integrity and Continuity. Actions include: Continue support for the development of uniform standards, common frameworks, HIT certification processes, common performance metrics, and supporting technology and structures. To help allay fears regarding confidentiality, expand liability protection for hospitals using HIT and for providers who comply with federal privacy regulations while using HIT networks.

Promote hospital-doctor connectivity by allowing hospitals to subsidize portable, standardized HIT systems for doctors which would require relaxing the current laws that prohibit such subsidies.

Key Findings

These actions call for little or no new federal funding. Develop targeted investments and incentives to promote HIT.

Choosing a Career in Health Informatics

Set up a pay-for-use program for those providers using certified, interoperable HIT systems. Additional actions include: Create a national performance-reporting infrastructure to receive and report comparative performance data. Fund research on pay-for-performance incentives. Educate consumers about the value of HIT in improving their ability to manage their own health. These actions require a moderate initial investment in policy and infrastructure development, with larger investments in later years. For example, pay-for-use programs, which are relatively easy to implement, could be followed by broad-based pay-for-performance programs, which require substantially more development.

Direct subsidies would greatly speed HIT adoption. Subsidies may be particularly important in overcoming barriers to network development. Actions include: Institute grants to encourage the development of organizations, tools, and best practices to help HIT succeed. Make direct subsidies to help selected providers acquire HIT.

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Extend loans to support the start-up and early operation of HIT networks. Convincing individual physicians and their patients of the value and safety of networking confidential data will be critical. Overcoming these challenges requires ongoing investment in framework, standards, and policy development. Widespread adoption of HIT and related technologies, applied correctly, could greatly improve health and healthcare in America while yielding significant savings.

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A range of policy options could be used to speed the development of HIT benefits. Government action is needed; without such action, it may be impossible to overcome market obstacles.

Journal of Medical Internet Research

Our findings strongly suggest that it is time for government and other payors to aggressively promote the adoption of effective Health Information Technology. Richard Hillestad , James H. Bigelow , et al.