Focused efforts needed to help health IT reach its promise

October 27, 2020

Despite significant investment in health information technology such as computerized health records and clinical decision support, leveraging the technology to improve the quality of care will require significant and sustained effort by health systems, according to a new RAND Corporation study.

In order to accelerate change, better mechanisms for creating and disseminating best practices are needed, in addition to providing advanced technical assistance to health systems, according to the analysis based on in-depth interviews with leaders from 24 health systems.

The study is published online by the journal Healthcare.

"Health systems are spending the most effort on foundational activities such as standardizing data and work processes that may not directly improve performance, but lay the groundwork for doing so," said Robert S. Rudin, the study's lead author and a senior information scientist at RAND, a nonprofit research organization. "Our study findings may help explain why the hoped-for IT-enabled transformation in health care has not yet occurred."

The study suggests the policy debate should move beyond federal incentives and requirements to adopt health IT. Instead, there should be a reorientation toward supporting efforts that create and disseminate best practices for how to optimally leverage the technology to improve performance. Payment reform is helping to introduce better incentives but may be insufficient.

"Leveraging IT to improve performance requires significant and sustained effort by health systems, in addition to significant investments in hardware and software," Rudin said. "To accelerate change, better mechanisms for creating and disseminating best practices and providing advanced technical assistance are needed."

Health system executives said that standardizing data and analytics across an organization was necessary to use the data for future activities to achieve high performance, such as monitoring areas for improvement. Health systems that were less advanced in this area were just beginning to establish a data analytics department, and planned for it to be operational within a few years.

"Some health systems clearly had developed or adopted best practices for using health IT that others had not," Rudin said. "It is likely that many health systems are spending considerable effort rediscovering the same lessons that others have already mastered. If lessons could be disseminated better, it could make a huge difference."

Federal officials in 2009 passed legislation that prompted a majority of physicians and hospitals to adopt electronic health records. The investment was expected to improve the health of Americans and the performance of the nation's health care system.

Despite the investment, the study notes that the performance of health systems across the U.S. continues to lag. The information technology revolution that has catalyzed transformations in industries such as finance and commerce has yet to yield the quality and cost improvements in health care that policymakers intended.

Researchers from the RAND Center of Excellence on Health System Performance collected information from 24 health systems across four states (California, Washington, Minnesota and Wisconsin).

A total of 162 executives from the health systems were interviewed about their experiences implementing health IT and whether IT is enabling them to make making meaningful changes in quality and cost control.

The researchers found a series of IT-related activities that could lead to higher performance, which were sorted into two broad categories: laying the foundation for performance improvement and actually using IT to improve performance. While the types of activities described were similar across health systems, some health systems were more notably advanced than others in their progress within these activities.

For health IT to make a big change in performance, the researchers say health systems may need direct help to accelerate change, such as through the widespread dissemination of proven best practices, and more targeted technical and implementation assistance.

"The benefits of health information technology won't come overnight - there's no silver bullet," Rudin said "Most health systems are working on building the foundation. It suggests patience and sustained effort over years and even decades is needed to realize the major benefits of health IT."
This study was funded under the U.S. Agency for Healthcare Research and Quality's Comparative Health System Performance Initiative, which seeks to study how health care delivery systems promote evidence-based practices in care delivery.

Other authors of the study are Shira H. Fischer, M. Susan Ridgely, Dmitry Khodyakov, Lea Xenakis and Cheryl L. Damberg, all of RAND, Yunfeng Shi of Pennsylvania State University, and Paul G. Shekelle of RAND and the West Los Angeles Veterans Administration.

RAND Health Care promotes healthier societies by improving health care systems in the United States and other countries.

RAND Corporation

Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to