Economic Impact of HIT

A lot of money is being spent by governments, providers and payers to wire up all of health care in the belief that quality will improve and costs, health and administrative, will be lower.  Are these outcomes being realized?  It may simply be too soon to tell but a study published in the Journal of the American Medical Informatics Association attempts to find an answer from the plethora of recent studies on the subject.    (JAMIA Article)   The authors examined  42 papers, 33 deemed high quality, which contained an economic evaluation on some form of health information technology.  Overall they judged that 23 papers had positive findings on the information system being studied providing a financial return and two were negative, while eight were inconclusive.  As the authors note, there is such a wide range of systems studied, in such varied settings and with different evaluation methods, that coming up with a rational analysis is difficult.  Our assessment of this paper and the studies cited is that while many appear to be positive, there are numerous limitations and flaws, and no clear conclusions can be drawn.  Providers, in particular, seem to be quite dubious about whether the costs they are incurring are providing a benefit and high systems costs seems to be a factor in driving physicians to affiliate with hospitals, or even payers.  We remain highly, highly skeptical that HIT will provide either an administrative or a health cost savings in the short, medium or long term.  Quality improvements seem more likely, and that should be the primary goal of our system.