EHRs Not Doing the Job Yet

Health information technology hasn’t lived up to its hype, or promise, depending on your perspective.  Why is anyone surprised, when it was apparent that a lot of what was promised was hype.  In 2005 some Rand researchers speculated, and that is the right word, that health information technology would save $80 billion a year and improve quality.  That hasn’t happened.  Now Rand has written an article in Health Affairs regarding the failures of health information technology and what may yet be done to improve the situation.   (HA Article)   The authors stick to Rand’s guns to some extent by suggesting that HIT still has great potential to transform the health system but slow adoption of things like EHRs and poor design and implementation have hindered productivity and quality gains.  In particular they emphasize the failure of systems at various providers and payers to be interoperable or even interconnected.  And while the meaningful use incentive program has sparked an upsurge in EHR adoption, a large number of providers still do not have comprehensive systems.  Few patients routinely access their medical records or use HIT for other purposes.  The systems that have been implemented often cause productivity decreases, taking a great deal of time for implementation and training and causing reworked care processes that upset daily routines.  In some cases HIT has actually decreased patient safety and the bulk of the research fails to show any significant improvement in patient health outcomes as a result of HIT adoption.  The authors suggest that addressing these issues would allow HIT to show value, but we doubt that it will ever come close to the panacea it has been portrayed to be.  The problems of health care have little to do with lack of information automation.  That doesn’t mean it isn’t a good idea to have greater use of information technology and it does mean we should be cautious in what benefits we should expect to receive from it.