Today, each hospital, doctor’s office and physician practice selects health information technologies (HIT) to solve the challenges they see, at a price point they can afford. And the result is universal dissatisfaction. I’ve never met a provider who said their systems were perfect, interoperable conduits of information across healthcare settings, and I’ve definitely not heard they deliver a strong ROI.
There’s unhappiness for two basic reasons. One is that today’s HIT operates as a collection of incompatible components stitched together across platforms until it resembles Frankenstein’s monster. The other is the inherent limitations seen in electronic health records (EHRs).
Part of the fault is public policy. You need only look at the results of the stimulus law and the related HITECH Act of 2009, which unleashed nearly $20 billion to providers who purchase EHRs, for a case in point. With new money on the table, the result was a feeding frenzy as providers scrambled to put in place systems that would qualify them for meaningful use incentive payments, and avoid payment cuts that are set to take effect in less than three years for those that lag behind. The end result has been incessant chatter about buying and building EHR, with no thought about how those systems interact with legacy technologies, how they could be used to create better patient outcomes and whether they support collaboration and new workflows.
if HIT were able to predict future health events and enable doctors to make better, more customized decisions before a patient arrived complaining of a problem. EHR alone can’t do that. But built the right way, HIT could consist of data warehouses that catalog the evidence, and applications that provide relevant content on demand to support a range of clinical decisions, engage providers through their choices, make smart predictions and access others’ work automatically without tons of custom programming.
So what should an ideal HIT system look like?
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