Questioning A Given

Health information technology (HIT) is often cited as a means to achieve improvements in efficiency and savings. But, I was wondering today: has anyone conducted any studies on what, if any, tangible improvements a healthcare provider enjoys after the adoption of HIT.

I wanted to question the assumption that HIT makes anything better for providers. So let's start from the beginning and ask this question:

What precisely gets better with the adoption of HIT into a practice?

I did some Googling and searched some academic databases through my alumni accounts, and there are many individual studies and articles on the subject. I managed to locate a research article that first appeared in the Annals of Internal Medicine in 2006 by Chaudhry et al. that conducted a literature review of over 250 studies on the impacts of information technology on healthcare, which is a lot more exhaustive and scientific than my own random searching could ever hope to be. Here is a link to the original paper.

The results were interesting, and perhaps not what one would expect. According to the research, information technology improved healthcare in four key areas:

1) the adherence to treatment protocols
2) the surveillance of diseases
3) the reduction in medication errors
4) the decrease in utilization of care

The first three improvements can be grouped together as improvements in the quality of care: patients were treated according to the plans with the best clinical outcomes, more data on diseases were gathered and used to proactively identify high-risk patients, and mistakes in prescribing drugs to patients were reduced.

The fourth improvement is different in that it suggests a gain in efficiency. Apparently, when clinicians are exposed to the cost of a given treatment, especially in the areas of diagnostics and imaging, utilization of these services decreases. This does not imply that the patient's treatment outcomes were better as a result of this efficiency, just that the efficiency appeared.

There is a robust debate about the place of information technology in healthcare, and I hope that by understanding how it can help a practice we can help to set our expectations appropriately. If we can do that for ourselves, and for our clients, HIT implementations will have a better chance of being perceived as a success and might be used to do what they do best: get better information in the hands of our caregivers when they need it.