Patient-Centered Health IT

Patient-centered care is identified by the Institute of Medicine as one of the six major domains of health care quality.  Health information technology is helpful to, if not necessary for, the provision of such care, which has as key attributes shared decision-making and better patient-physician communication, with attempts to ascertain patient values and preferences and respect those in making care decisions.  An Agency for Healthcare Research and Quality report looks at the state of evidence regarding the use of HIT to facilitate patient-centered care.   (AHRQ Report)  The report was put together from a literature scan of over 300 relevant research articles.  One question examined was the effect of HIT applications like clinical decision aids, IT-guided disease management and telemedicine systems on process of care outcomes.  Overall the research suggests that HIT has a positive effect on outcomes, improving compliance with process of care standards.

A number of the included studies also looked at the effect of HIT on clinical outcomes, often in the context of single disease management programs.  Again, in general the research suggested a positive effect on outcomes, with telehealth systems showing the strongest evidence, but overall the evidence for improved clinical outcomes was limited.  A few studies dealt with HIT’s effect on patient responsiveness and also found a limited positive effect.  HIT applications intended to facilitate shared decision-making were also involved in some studies, with again a positive effect on patient knowledge and patient communication with providers.  Some barriers to greater use were inadequate training for patients and providers, poor system and interface design, low general computer literacy, privacy protection, workflow interference, and cost.  While HIT seems to benefit patient-centered care, the report cautions that there is no real evidence on the cost or the ratio of benefit to cost.