HHS Finds IT Boosts Quality, Efficiency Of HealthcareHHS Finds IT Boosts Quality, Efficiency Of Healthcare

Health IT Boosts Patient Care, Safety

A study conducted by the Office of the National Coordinator for Health Information Technology (ONC) in the Department of Health and Human Services (HHS) has found that 92% of recent articles showed that health IT (HIT) has an overall positive effect on key aspects of care, including quality and efficiency of healthcare.

Published in the March issue of Health Affairs, the study also found that some providers are dissatisfied with electronic health records (EHRs) and that their discontent with unsatisfactory technology or technology support is a barrier to achieving the potential of health IT.

Nevertheless, the report, "The Benefits of Health Information Technology: A Review of the Recent Literature Shows Predominantly Positive Results," concludes that health IT improves the overall quality of care and that the results validate the Obama administration's decision to increase health IT spending, which the report describes as a worthwhile endeavor.

David Blumenthal, national coordinator for HIT and one of the authors of the review, said in a statement: "This article brings us much more up-to-date, both in our confidence regarding the overwhelming evidence of the benefits of adoption and use of HIT, and also in our understanding of problem areas that still need to be addressed."

Just last month, Blumenthal criticized the results of a Stanford University study that showed that the use of EHRs did not significantly improve the quality of patient care, even when they were used with clinical decision support (CDS) systems that help health professionals make clinical decisions to better manage patient care.

Blumenthal said the Stanford study was flawed because the data was collected from 2005 to 2007 and is based on outdated health IT systems. He said the data did not reflect health IT systems in their modern form.

By contrast, the ONC study, which used methods that were employed by two previous independent reviews, included articles published from July 2007 up to February 2010, following up on earlier reviews of the literature from 1995 to 2004 and from 2004 to 2007.

The authors also said they included peer-reviewed publications assessing the effects of EHRs; computerized provider order entry (CPOE); CDS systems; health information exchanges (HIEs); e-prescribing for outpatients; patients' personal health records; patient registries; telemedicine or remote monitoring; information retrieval; and administrative functions.

"This review is important because it helps us correct for the lag in evidence that occurs naturally in the dynamic HIT field, where changes in technology and accelerating adoption cause the old literature to become quickly outdated," Blumenthal said.

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This latest ONC review initially surveyed more than 4,000 peer-reviewed articles, which was culled to 154 papers that qualified for the parameters of the study.

The review found positive results in 96 of the articles (62%), and mixed but predominantly positive results in 46 other articles (30%). Ten articles, or 8%, were found to have negative or mixed-negative results.

In addition to quality and efficiency of care, the authors categorized additional outcomes including access to care, preventive care, care process, patient safety, and provider or patient satisfaction.

The study also said that larger institutions that adopted health IT earlier, such as Intermountain Healthcare in Salt Lake City, Partners Healthcare in Boston, and Regenstrief Institute in Indianapolis, are not the only ones realizing the benefits of health IT. There is now growing evidence that smaller medical practices are improving patient care through digitized medical record systems.

Other positive results highlighted in the article include:

-- At three New York City dialysis centers, patient mortality decreased by as much as 48% while nurse staffing decreased by 25% in the three years following implementation of EHRs.

-- In an inpatient study, a CDS tool designed to decrease unnecessary red blood cell transfusions reduced both transfusions and costs, with no increase in patient length-of-stay or mortality.

-- A study of 41 Texas hospitals found that facilities with more advanced HIT had fewer complications, lower mortality, and lower costs than hospitals with less advanced HIT.

Negative findings in the study were most often associated with provider or staff satisfaction related to difficulties in transitioning from paper-based to electronic-based records and care.

The article noted that these findings "highlight the need for studies that document the challenging aspects of implementing HIT more specifically and how these challenges might be addressed," such as through strong leadership or staff participation when adopting and implementing HIT.

"These new findings are very significant in helping to confirm that our nation has made the right choice in moving aggressively toward adoption of health information technology," Donald Berwick, administrator of the Centers for Medicare & Medicaid Services (CMS), said in a statement.

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009, as much as $27 billion in Medicare and Medicaid incentive payments will be available to eligible professionals, eligible hospitals, and critical access hospitals when they adopt certified EHR technology and successfully demonstrate "meaningful use" of the technology in ways that improve quality, safety, and effectiveness of patient-centered care.