Systems that send real-time updates to doctors or other medical professionals can help healthcare providers detect problems earlier and quickly adjust treatment plans. Proponents of information technology in healthcare argue that these innovations offer many benefits to both caregivers and patients. However, the benefits have yet to produce results that meet the expectations of many health care advocates. While technology delivers noticeably better organizational performance, not all innovations always work as their developers expected.
The best evidence of such a change is the beneficial effect on preventive care of using automated reminders for patients. Telemedicine and consumer health informatics also have limited evidence of benefit in specific contexts. The evidence is much more limited about the health effects of more general and interactive health information technologies, such as the Internet or email, or the effect on patient trust and satisfaction of the implementation of HIT systems such as the electronic health record. When these 15 studies were examined for their HIT functionality using the classification system developed by the Institute of Medicine, 4 of them referred only to decision support and 4 evaluated HIT systems with decision support and administrative processes. The remaining seven studies focused on other unique functionalities or combinations of up to three functionalities. We could not find a single study that used a randomized or controlled clinical trial design, that did not report data from any of the major academic or institutional or U.K.
We also searched the Cochrane Controlled Clinical Trials Register Database and the Cochrane Controlled Clinical Trials Register Database of Reviews of Effectiveness. The Cochrane Collaboration is an international organization that helps people make informed decisions about health care by preparing, maintaining, and promoting the accessibility of systematic reviews on the effects of care interventions. In December 2004, we also conducted a specific search in the journal Health Affairs, developing a list of all articles with “information technology” or “information systems” as keywords. At the time of this report, another RAND team was working on a project titled “Harnessing Modern Information Technology to Transform Healthcare Delivery.” This project, funded by private industry, aimed to propose policy changes that are likely to increase the adoption rate of HIT in the United States. Part of the project was to assess the effects of information technology on costs, health outcomes and side effects.
The second barrier identified was high costs, with estimates from previous studies for the cost of CPOE ranging from $3 million to $10 million, depending on the size of the hospital and the level of existing information technology infrastructure. Respondents reported that many products from current vendors did not meet their hospital’s needs and that extensive software customizations were needed to accommodate the established workflow in the hospital. However, most medical organizations and health care providers have been slow to adopt HIT. The decision to implement health information technology must carefully weigh the costs and benefits of including it in the clinical setting. This is especially true in environments involved in infant and child health care, where practice patterns and physician needs are unique.
Having this information at your fingertips can help patients feel more connected to their care and help improve health outcomes. But today, patient outcomes are better than ever, and that’s largely due to technological advances. Surgical techniques, superior imaging, electronic medical records, and telemedicine Medical Device News Magazine have all played an important role in improving overall medical care. While health information technology is huge in form and function, its core is its ability to better store and transmit information. An important part of health information technology is the electronic health record or EHR.
In short, evidence for an effect of HIT on patient-centered care in healthcare is scarce. The best evidence is the beneficial effect of using automated patient reminders for preventive care. Evidence for the benefits of telemedicine and consumer health informatics is also limited to specific contexts. Finally, the evidence is much more limited for the effects of more general interactive HIT or the effect of implementing HIT systems on patient trust and satisfaction. An EHR system can facilitate, among other things, the automatic generation of patient reminders for preventive services, detection and disease management. Another study used automated pharmacy registries to generate patient feedback and compared the effectiveness and cost-effectiveness of two depression care programs.61 Feedback with care management was significantly better than feedback alone.
In this case, implementing HIT costs the hospital money and reduces hospital revenues, even if implementing HIT delivers net cost savings from a societal perspective. This technology-based strategy has proven effective in reducing the effects of human error in industries such as banking and aviation. These systems, when integrated into larger HIT systems, can improve medical decision-making and the proper use of diagnostic tests and therapeutic agents. The literature is even scarcer in terms of information about the organizational context of a HIT implementation. The report notes that the smaller medical practices and hospitals that make up the majority of the country’s health care providers, on the other hand, have limited technological expertise and must rely on the purchase of commercial systems. Data on healthcare IT deployment in these environments is very limited, according to the report.
The aim of this study51 was to evaluate the effects on care processes of the integration of electronic guidelines for HIV outpatient care into EHR. One year after the implementation of the EHR guidelines, the number of eligible patients receiving recommended HIV care in the alert intervention group was 85 percent versus 64 percent in the control group. All findings were statistically significant at a p-value of 0.05, except for starting AZT/DDI or changing the dose of AZT. The median response time for a healthcare provider to request appropriate services in response to new clinical information was 11 days in the intervention group and 52 days in the control group. Decision support was provided to providers online and without the provider asking for it.