The Benefits Of Health Information Technology: A Review Of The Literature Shows Predominantly Positive Results

Authors from the Office of the National Coordinator for Health Information Technology (ONC) published a review in the March issue of Health Affairs focusing on the effects of health information technology (health IT). The study found predominantly positive effects on key aspects of care including quality and efficiency. In addition, providers outside of large integrated care networks, the original innovators in health IT, are beginning to implement, evaluate, and achieve benefits from similar systems.

Purpose of the Study

Before this study, the most recent comprehensive review on the effects of health IT covered articles between 2004 and 2007. This previous review found limited evidence of benefits that most often accrued to traditional innovators in health IT, such as the VA and Kaiser Permanente. The purpose of this updated review was two-fold: (1) to help correct the gap in reviews of the evidence, especially as adoption has accelerated in recent years; and (2) to help determine if benefits are more widely attainable.

Primary Findings:

• The authors identified 154 peer-reviewed studies from July 2007 to February 2010 on the effects of health IT on care delivery and provider and patient satisfaction.
• The authors found over 92% of the studies reached positive overall conclusions on the effects of the health IT implementation(s).
• Statistical analyses also show that studies emerging from traditional health IT “leaders” are no more robust in their evaluation methods or positive in their conclusions, suggesting providers outside these original innovators in health IT are beginning to implement, evaluate, and experience benefits from health IT previously reserved for large integrated networks.
• However, the authors also found studies examining provider satisfaction are more likely to have negative findings. This finding highlights the importance of the "human elements," such as strong leadership and staff support for the change, when transitioning to health IT.

The article is available here.

A Snapshot of Electronic Prescribing

E-prescribing is a no-brainer. It is more convenient, cheaper for physicians and pharmacies, and safer for patients. With e-prescribing, patients have to make only one trip to the pharmacy, to pick up the prescription. E-prescriptions make jokes about a doctors' illegible handwriting, and the very not-funny medication errors that can result, a thing of the past. Advanced e-prescribing systems can save lives by, for example, checking for potential interactions among the drugs a patient is prescribed. All told, electronic prescribing is an important component of health information exchange that can save lives, lower costs, and improve care.

Evidence of the benefits of health information exchange such as e-prescribing is mounting. Some relevant recent studies include the following:

• Researchers at the Center for IT Leadership (2010)  studied the US Department of Veterans Affairs, an early adopter of health IT and exchange, and estimated that savings from preventing adverse drug events alone totaled $4.64 billion.
• Frisse and Holmes (2007) found that health information exchange can save cities millions both by lowering administrative costs and by improving preventative health care. For example, Frisse and Holmes estimate that the Memphis, TN region could save over $8 million a year through a regional health information exchange.
• In Indianapolis, Finnell and Overhage (2010) found that a majority of emergency medical professionals said they benefitted from access to pre-existing health information through electronic exchange. The information, which included medication lists, allergies, and past medical histories, was especially useful to the medics when caring for frequent emergency patients and patients who were unconscious, uncooperative, or elderly.
• Shapiro et. al. (2011) examined health information exchange projects in 48 states and found that while the projects faced some financial and technical hurdles, they had enormous potential to improve the efficiency and quality of public health reporting, facilitate public health investigation, improve emergency response, and enable public health officials to communicate information to the clinical community.
• Persell et. al (2011) found that electronic health records can use information on patients' medical histories to improve quality significantly by reminding providers of the best methods of care.

Studies Show: Better Patient Outcomes with EHRs

1. ¹ Ciemins EL, Coon PJ, Fowles JB. "Beyond health information technology: Critical factors necessary for effective diabetes disease management", Journal of Diabetes Science and Technology. 3:3;2009.
2. ² Baron RJ. "Quality improvement with an electronic health record: achievable but not automatic", Annals of Internal Medicine. 147:8;2007.
3. ³ Duffy L, et. al. "Effects of electronic prescribing on the clinical practice of a family medicine residency", Fam Med. 2010;42(5):358-63
4. ⁴ Hunt JS et. al. The impact of a physician-directed health information technology system on diabetes outcomes in primary care: a pre-and post-implementation study. Informatics in Primary Care. 2009;17:165-74.
5. ⁵ Bell LM, Grundmeier R, Localio R, Zorc J, et al. Electronic health record-based decision support to improve asthma care: a cluster-randomized trial. Pediatrics. 125(4):e770-7, 2010 Apr.
6. ⁶ Fiks AG, Grundmeir RW, Biggs LM, Locallo R, Alessandrini EA. "Impact of clinical alerts within an electronic health record on routine childhood immunization in an urban pediatric population", Pediatrics. 120(4):2007;707-14.
7. ⁷ Holt J, Warsy A, Wright P. "Medical decision making: guide to improved CPT coding", Southern Medical Journal. 103(4):316-22, 2010 Apr. AHRQ Publication No: 09-0095 dated September 2009.