A Look at Health Information Technology in the United States

This week, Health Affairs brought together key players in health information technology (HIT) for a briefing on recent trends in the adoption of electronic health record (EHR) systems in the United States. Coinciding with the briefing, the Robert Wood Johnson Foundation released its Annual Report on HIT Adoption, shedding light on how HIT is driving toward delivery system change.     

David Muntz, MBA, principal deputy coordinator at the Office of the National Coordinator for Health Information Technology (ONC) commented that “the goals to achieve 'Meaningful Use' are ambitious but achievable”. According to Muntz, HIT can transform health and health care “by hardwiring the 3-part aim” of better health care, better health and reduced costs.

EHR adoption has been on the upturn since 2004 when the ONC was created and federal efforts aimed at primary-care specialists and small practices kicked-off. The “game-changer” year was 2011, when one in 10 physicians and hospitals adopted an EHR. However, out of about 50 percent of  office-based physicians reporting use last year, only about 30 percent had basic systems with the potential to improve quality and efficiency of care and fewer than one in five hospitals met the proxy for Meaningful Use.  Furthermore, smaller, non-teaching, and rural hospitals lagged behind, as did physicians in non-primary care, small practices, and those over 55 years old.

Ashish Jha, MD, MPH, associate professor of health policy at the Harvard School of Public Health, assistant professor of medicine at Harvard Medical School and physician at VA Boston Healthcare System and Brigham and Women’s Hospital, declared that the US health care system is a mess, but that broad enthusiasm in the marketplace can help propel HIT and transform quality of care. According to Jha, the key is moving beyond the question “Does HIT improved quality and reduce costs?” to “How can HIT improve quality and reduce costs?”. He stressed that "it’s still early in the ballgame" and the US has made impressive progress given the size and complexity of the health care system. When he asked audience members if their doctors use EHRs, almost every hand in the room went up, a good indication that HIT is becoming more and more prevalent.

The panelists stressed that future federal efforts need to address five areas: hospitals and physician groups that are lagging behind; shortages of HIT professionals; discrepancies in vendor access; health information exchange infrastructure; and setting the bar for meaningful use Stage 2.

The American College of Cardiology will be submitting comments on Meaningful Use Stage 2 in the next few days. Stay tuned to CardioSource.org and The ACC Advocate for the latest Advocacy news. To receive up-to-date information from the ACC’s Advocacy Twitter account, follow @Cardiology.

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