The use of health information technology (HIT) holds tremendous promise in improving the efficiency, cost-effectiveness, quality, and safety of medical care delivery in the United States. The realization of these benefits is especially important in the context of reports that show several consecutive years of double-digit increases in healthcare costs. At the same time, reports have suggested a high percentage of healthcare dollars are wasted on inefficient processes. Legislators and organizational leaders at the federal and state levels have emphasized the need for healthcare to follow the example of other industries, where computer information technology has been critical in increasing the accessibility of crucial information, automating labor-intensive and inefficient processes, and minimizing human error.
One potential benefit of HIT is reduction of medical errors. A technology-based strategy has proven effective in industries such as banking and aviation. Clinical HIT systems may also have a substantial impact on medical quality and safety by integrating relevant automated decision-making and knowledge acquisition tools into the practice of medical providers, thereby reducing errors of "omission" that result from gaps in provider knowledge, or by or failure to synthesize and apply pertinent knowledge in clinical practice. These systems, used as stand-alone clinical decision-support tools, or integrated within larger HIT systems, may improve medical decision-making and appropriate use of diagnostic tests and therapeutic agents.
In the ambulatory healthcare environment, use of HIT can improve the efficiency and financial health of a practice.For years, many offices have used computerized scheduling and financial systems to track practice productivity and automate reimbursement processes. The use of ambulatory electronic health records (EHRs) offers an opportunity to monitor and improve clinical quality and streamline office processes by improving information access and reducing duplicative documentation. In addition, technology-based "e-prescribing" tools may improve the efficiency and safety of prescribing practices in the outpatient setting. Another potential benefit of widespread adoption of HIT use is the achievement of system connectivity and information exchange, between providers of the same organization, between organizations, and ultimately regionally and nationwide.
The adoption of HIT among a majority of medical organizations and providers has been slow. Recent reports of computerized physician order entry (CPOE) use show only 9.6% of hospitals have CPOE completely available for use, with only half of these hospitals requiring use of CPOE (Ash, Gorman, et al., 2003). In the ambulatory setting, recent estimates place the use of electronic health records at 6-15% of office-based physicians (Miller, Hillman, et al. 2004; Terry, 2005). Because widespread adoption of HIT has the potential to transform the efficiency, cost-effectiveness, timeliness, quality and safety of medical care delivery, we created an interactive searchable database to display scientific evidence on the relative costs, benefits, and barriers to implementing different HIT systems across the spectrum of healthcare environments.
Ash, J. S.; Gorman, P. N.; Seshadri, V., and Hersh, W. R. Computerized Physician Order Entry in U.S. Hospitals: Results of a 2002 Survey. Journal of the American Medical Informatics Association. 2003 Nov 21.
Miller, R. H.; Hillman, J. M., and Given, R. S. Physician use of IT: results from the Deloitte Research Survey. Journal of Healthcare Information Management. 2004 Winter; 18(1):72-80.
Terry, K. Exclusive Survey: Doctors and EHRs. Medical Economics. 2005 Jan 21; 82(2).