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Topics: Electronic health record, Health care, Medicine Pages: 66 (13812 words) Published: February 24, 2014
C H A P T E R

Information technology
in health care

7

C H A P T E R

Information technology
in health care

7

In this chapter

I

nformation technology (IT) has the potential to improve the



What is health information
technology?



Quality and health
information technology



Current status of health
information technology



Efforts to encourage faster
diffusion

quality, safety, and efficiency of health care. Diffusion of IT in health care is generally low (varying, however, with the application and setting) but surveys indicate that providers plan to

increase their investments. Drivers of investment in IT include the promise of quality and efficiency gains. Barriers include the cost and complexity of IT implementation, which often necessitates significant work process and cultural changes. Certain characteristics of the health

care market—including payment policies that reward volume rather than quality, and a fragmented delivery system—can also pose barriers to IT adoption. Given IT’s potential, both the private and public sectors have engaged in numerous efforts to promote its use within and across health care settings. Additional steps could include financial incentives (e.g., payment policy or loans) and expanded efforts to standardize records formats, nomenclature, and communication protocols to enhance interoperability. However, any policy to stimulate further investment must be carefully considered because of the possibility of unintended consequences.

Report to the Congress: New Approaches in Medicare | June 2004

157

By providing new ways for providers and their patients to
readily access and use health information, information
technology (IT) has the potential to improve the quality,
safety, and efficiency of health care. However, relatively
few health care providers have fully adopted IT. Low
diffusion is due partly to the complexity of IT investment,
which goes beyond acquiring technology to changing
work processes and cultures, and ensuring that physicians,
nurses, and other staff use it. In addition, certain aspects of the market—such as payment policies that reward volume
rather than quality and the fragmentation of care
delivery—do not promote IT investment, and may hinder
it. Because of its potential, policymakers need to better
understand how information technology is diffusing across
providers, whether action to spur further adoption is
needed, and if so, what steps might be taken. Any policy
to stimulate further investment must be carefully
considered because of possible unintended
consequences—such as implementation failures due to
organizations’ inability to make the necessary cultural
changes. This chapter is a first step in increasing our
understanding of the current state of IT in the health care
industry. The Commission will continue to work on this
issue.
Despite considerable attention to the topic, much remains
unknown about the role of IT in the health care setting.
What types of IT are being used? What is the link between
use of IT and quality improvements? How much
investment have hospitals and physicians already made in
information technology, and in what kinds? What factors
drive IT investments (e.g., financial returns, quality
improvement goals, other factors)? What factors hinder IT
investments and implementation (e.g., work flow changes,
lack of compatibility with other IT, costs)? What current
steps are being taken by public and private entities to
encourage further diffusion of IT? What additional actions
might make sense?
Delivering quality health care requires providers and
patients to integrate complex information from many
different sources. Thus, increasing the ability of
physicians, nurses, clinical technicians, and others to
readily access and use the right information about their
patients should improve care. The ability for patients to
obtain information to better...

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