This past Wednesday, October 3, The Bipartisan Policy Center (BPC) teamed with Doctors Helping Doctors to hold a conference discussing the current state of Health Information Technology (HIT) in America. In conjunction with the meeting, BPC published results from their survey, which asked doctors about their preferences and needs of HIT. The results suggest that HIT is not yet where it needs to be to justify the current push for adoption by the Obama administration.
Physicians are sometimes portrayed as stubborn mules who refuse to adopt anything new, but innovation is everywhere in the practice of medicine. Wednesday night in the first Presidential debate, Governor Romney discussed the innovation that he encountered on a visit to the Cleveland Clinic. When technology helps doctors do their job more efficiently and more effectively, they adopt, they learn, and they adapt. The incentives have to be there however, and with electronic medical records (EMR), they are not. Not yet at least.
Americans envision HIT as providing seamless transitions, perfect information sharing between doctors and patients, and valuable information at the doctors’ fingertips to assist in making critical decisions. There is not a doctor out there who will tell you that this image is not enticing. But the survey results clearly show that health information technology has a way to go before it can be utilized in the manner everyone wishes.
Doctors see the potential of electronic health records. The survey found that 80 percent of clinicians surveyed said electronic exchange of health information will improve patient care and care coordination. Furthermore, 69 percent said electronic information exchange would make their practices more efficient. While doctors recognize the instrumental potential that EHR and HIT hold, they also recognize its current downfalls. Policymakers must understand that HIT is not yet where it needs to be to provide the benefits and incentives for adoption.
The big push for improving and advancing health information technology has come with the push for more coordinated care in models like Accountable Care Organizations (ACO) and Health Maintenance Organizations (HMO). These institutions are seen as the model to improving coordination and quality while reducing costs through eliminating wastes born by poor communication. HIT is seen as these models’ invaluable tool.
Unfortunately however, the BPC survey found that 71 percent of doctors identify a lack of electronic health record interoperability and exchange infrastructure as major barriers to health information exchange. Additionally, 61 percent also recognize the cost of creating and maintaining interfaces and exchanges as a major barrier. These results show that, with current technology, doctors find HIT unable to operate its main function properly.
Health information technology no doubt carries valuable potential in advancing the quality of health care delivery. More coordinated care and information sharing can also reduce costs by cutting waste. As this survey’s results show, however, interoperability issues and poor information sharing capabilities inhibit the quality improvement that this technology supposedly promises. Instead of establishing artificial incentives, we must allow for the innovation that Governor Romney recognizes to take place in this market. Competition will improve this technology, just as it has in every other market. As soon as real incentives are established (i.e. helping doctors do their job better and more efficiently) doctors will be quick to adopt this technology.