Could Information Technology Save American Health Care?


By guest blogger Robert Field:

In some ways, American health care is still in the Stone Age. We are the most technologically advanced society in the world, but our health care providers have barely begun to use information technology. Fewer than half of them have any kind of information system, and fewer than ten percent of physicians have systems with full capabilities.

 The rest of the developed world is racing ahead and leaving us in the dust. In many countries, the use of IT in health care is almost universal (see MedPage Today). Among those that have reached this stage are Sweden, the Netherlands, New Zealand, England, and Norway.

 Health IT can do much to improve the quality of care.  It lets your doctor see all of your test results, prescriptions, and procedures in one place. It lets all of your doctors coordinate your care to avoid duplicating tests or ordering drugs with dangerous interactions. And perhaps most importantly of all, it eliminates a perennial cause of medical mistakes – poor handwriting.

So, why isn’t America more advanced in the use of health IT? One important reason is the fragmented nature of our health care system. Despite much recent consolidation, most physicians still practice on their own or in small groups. IT is extremely expensive, and many smaller physician practices simply can’t afford it. Another reason is generational. For many older and mid-career physicians, it is too late to change their ways.

Will America catch up? There is a major federal effort under way to get us there.  The HITECH Act, which was passed as part of the economic stimulus bill in 2009, allocated $47 billion to promote the use of health IT. Much of it is in the form of incentives to doctors and hospitals to adopt electronic medical records (see Kaiser Family Foundation Issue Brief ).  

The effort is administered by the office of the National Coordinator for Health Information Technology, a component of the Department of Health and Human Services that was created by the Bush Administration. The HITECH Act faces many hurdles. The National Coordinator has labored to produce regulations to determine which providers will be eligible for the incentives.  The law stipulates that they must use of IT “meaningfully” to merit federal support. It is also not yet clear whether $47 billion will be enough to jump-start the effort.

Nevertheless, a lot is at stake. We won’t get the best health care of the future with the technological tools of the past.



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