Functional gaps in attaining a national health information network. What will it take to get there in five years?

Authors: 
Kaushal, R., Bates, D. W., Poon, E. G., Jha, A. K., Blumenthal, D.
Journal: 
Health Aff (Millwood)
Publication Date: 
2005 Sep-Oct
Volume: 
24
Issue: 
5
Pages: 
1281-9
  • HIT Description: A model National Health Information Network. More info...
  • Purpose of Study: To determine the HIT functionalities needed to create a model national health information network within five years. The authors first defined the gap between the HIT functionalities specified in the model and the estimated HIT functionalities in five years if current rates of adoption continue.
  • Years of study: Not specified
  • Study Design: Predictive analysis
  • Outcomes: Gaps in HIT functionalities
Summary:
  • Evaluation Method: An expert panel was convened. The panel followed a modified Delphi process. Literature review and case studies of healthcare stakeholders in Denver and Boston were done to determine levels of HIT functionality in these markets (results presented separately). Critical stakeholders in a national network included physician offices, hospitals, skilled nursing facilities, home health agencies, clinical laboratories and pharmacies.
  • Description: Key functionality of a national health information network to be established in five years included inpatient/ outpatient results viewing, EHR, CPOE, electronic claims submission, electronic eligibility verification, secure electronic patient communication, and electronic prescriptions.
  • Implementation: In five years it was projected that automated claims submission would be available in 99% of large hospitals and 86% of home health agencies. Automated eligibility verification was projected to range from 53% for small physician offices to 92% of pharmacies. The most frequently used clinical functionality was projected to be results viewing with approximately 45 to 65% of physician offices, 65% to 80% of hospitals, 85% of laboratories, 25% of skilled nursing facilities and home health agencies having access to electronic results. EHR was projected to be in use in 25% to 35% of physician offices, 30% to 40% of hospitals, 15% of skilled nursing facilities and 20% of home health agencies. CPOE was projected to be in use in 20% to 30% of physician offices, 35% to 55% of hospitals, and 15% of skilled nursing facilities.
  • Barriers: Financial factors, adoption of standards, privacy and security issues were thought to be the major barriers.