Health information technology–collecting, analyzing and sharing data electronically–sounds like a great idea. Such a great idea that the federal government has spent billions and billions of dollars promoting it and providers and plans have spent billions and billions of dollars complying with these regulatory initiatives. And the whole point was that health spending would go down and quality would improve. So that must be what happened. Well, not really according to a report from the Robert Wood Johnson Foundation, Mathematica, Harvard and the University of Michigan which assesses the state of our HIT efforts. (RWJ Report) This report is truly outstanding, a wonderful compendium of information about a variety of health information technology efforts.
In terms of results, the federal HiTech Act did seem to spur greater use of EHRs, with 75% of hospitals using at least a basic EHR in 2014 and 50% of physicians doing so, although 82% of doctors have some kind of EHR even if it doesn’t meet the federal definition of a “basic” EHR. One revealing statistic, however, is that in the last year a number of clinicians, apparently discouraged, have given up trying to get meaningful use payments. And it has to be discouraging that such a large number of providers, especially hospitals, still don’t have even a basic EHR and the vast majority of providers are not using EHRs or other health information technology for the purposes envisioned by the federal initiatives. Health information exchange continues to be problematic for many uses, although most providers report some minimal adoption of the capability. Funding models for broad data sharing exchanges are a major issue. And while only addressed in passing, a number of surveys and other studies have found that physicians are frustrated with HIT, often feeling it is expensive and creates burdensome workflows and takes away from patient time. And there is little credible research suggesting that it actually improves health outcomes or reduces health spending, especially after taking the cost of the technology into account. Health information technology should be beneficial in theory, but we appear to be a long way from making that a reality.