QUESTIONS AND ANSWERS ABOUT HEALTH INFORMATION TECHNOLOGY

1. Why is health information technology so important? Will it really improve health care quality?

Health information technology reduces medical errors.  One university hospital that uses bedside bar code technology cut medication errors by 89 percent, improved emergency room documentation accuracy by 85 percent, and reduced overall discrepancies in details by 71 percent. These statistics translate into better health care.

Health information technology also increases patient safety and satisfaction.  Health IT has been shown to give quicker access to clinical information, cut waiting times, reduce repeat appointments and redundant lab tests, and cut paperwork while making data collection simpler.

2. What barriers exist to widespread adoption of health information technology? Are they significant enough to necessitate government intervention?

A variety of obstacles hinder more widespread adoption of information technology in the health system, including legal, financial, cultural, and technological barriers. Progress toward interoperable electronic health records is also slowed by the lack of a uniform federal standard for the privacy of electronic health information.

Several steps would help solve the problems that keep HIT from broader dissemination.  The federal government should foster the development of comprehensive standards of data exchange.  Legislation to facilitate the adoption of HIT should establish a uniform federal standard for privacy and security of health information. Federal financing is necessary so all health providers can acquire IT. In addition, best-practices collaboration will promote IT implementation.  The lessons learned by “early adopters” will help develop best practices. Information-sharing of this kind will bring down the costs of IT adoption.

3. How much funding will be required to achieve widespread adoption of HIT? Is federal funding necessary?

A recent study by RAND Health estimated that implementation of HIT would
cost around $8 billion per year, assuming adoption by 90 percent of hospitals and doctors’ offices over 15 years. The vast magnitude of resources necessary for widespread adoption suggests that the federal contribution will be integrally important. However, HIT will also save money; the return on investment will be worthwhile for the federal government and industry.  The same RAND study estimated the annual savings from efficiency alone could be $77 billion or more. As the largest payer of health care, the federal government has an interest in greater systems efficiency.

4. Why is a uniform federal standard for privacy necessary for the adoption of HIT? Isn't the current system adequate?

The federal Health Insurance Portability and Accountability Act (HIPAA) standards are only a privacy floor. Health care entities regulated by HIPAA must also comply with state privacy laws.  As a result, providers, clearinghouses, and health plans are required to comply with the federal law as well as many conflicting and duplicative state privacy restrictions.  Thus, making information available across state lines through or to a national health information network (NHIN) could require entities to comply with a number of state laws each time they disclose information in the context of a federated system. This will be a significant disincentive to stakeholders’ participation.

Many organizations have noted the need for a federal uniform privacy standard for HIT adoption.  The 11-member Commission on Systemic Interoperability (CSI), authorized by the Medicare Modernization Act (MMA) to develop recommendations on HIT implementation and adoption.  CSI called for the American Health Information Community (AHIC) to build on the HIPAA privacy and security regulations to develop national standards for authentication, authorization, and security. This will ensure the necessary infrastructure for consumers' confident adoption of health information technology.