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Health IT Continues to Lag Despite Federal Investments

By Nellie Bristol, CQ HealthBeat Associate Editor

January 30, 2012 -- The slow pace at which health care providers are adopting health information technology could limit the availability of more efficient, cost-effective models of care, according to a recent study by the Bipartisan Policy Center.

The ability to electronically track patient populations, move information easily among different health care providers and give patients better access to their own health data is critical to establishing more coordinated health care organizations, according to the report. But, it adds, expansion of health IT is hindered by payment systems based on volume of care and poor information exchange networks.

"Health IT plays a critical role in supporting patient-centered care, yet the use of electronic tools to coordinate care, drive provider-patient communication, and empower patients to manage their health and health care is not widespread," the report said. Movement toward digital health records is lagging as well, it said. "While EHRs are a necessary foundational component for new models of care, the level of EHR adoption ... among physicians, hospitals and provider organizations remains low."

Both President Obama and President George W. Bush made health IT a priority, calling for everyone to have electronic medical records by 2014, an achievement that seems unlikely.

The group recommends that health care payers align payments to encourage coordinated care with the use of health IT, that the federal government collaborate with the private sector to better enable the exchange of health information, that the public and private sectors develop education and training programs to increase consumer awareness of health-related electronic tools, and that state and federal officials continue to ensure patient privacy standards will continue to be at least as comprehensive as those in the health insurance portability law (PL 104-191).

Despite federal investments in helping providers get up to speed, many of the problems hobbling expanded health IT are longstanding, according to Jennifer Covich Bordenick, CEO of eHealth Initiative, a national organization of health care-related groups working on improved health IT. "The report re-emphasizes what a lot of us in the industry have been saying for years," she said.

She says the top two problems are standards and finances. "Doctors aren't necessarily paid to do any of this. Given the financial constraints and the environment we're in right now, it's really difficult to do anything you're not incentivized to do financially. That's a huge issue."

In addition, the federal government and other stakeholders have been trying to develop uniform standards for electronic communications, but that also remains unresolved. "That's something that really has not been determined yet, and until we all speak the same language, it's going to be difficult to do this," Covich Bordenick said. "Somebody needs to make some decisions about standards, and it just needs to happen."

Federal funding, authorized at $30 billion under language in a 2009 law (PL 111-5) designed to promote the adoption and use of health information technology, has done a lot to spur increased use of health IT, the report said. Covich Bordenick agreed. But, she said, the effort needs market forces in the form of better private sector economic incentives to finish the job. Where federal government action is critical, she added, is development of privacy standards that control who owns the information and who is allowed to look at it. Those policies, she said, are a task that now frequently occurs at the state level, resulting in myriad different policies. "It just makes it a lot rockier," she added.

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