Research shows that health information technology clearly improves quality of care in large healthcare organizations that create their own systems and devote substantial resources to electronic health records, computerized physician-order entry, electronic prescribing and other applications, Carolyn Clancy, director of the Agency for Healthcare Research and Quality told attendees of the Joint Commission on Accreditation of Healthcare Organizations' 20th annual national Conference on Quality and Patient Safety in Chicago on Thursday.
For the rest of the healthcare industry, however, Clancy said the situation is not so good.
Current statistics show that only 14.1% of all medical groups use EHRs, and only 12.5% of practices with five or fewer full-time physicians use them.
"On the hospital side, the news is much more depressing than that," Clancy said, explaining that even at institutions where IT systems have been implemented, applications such as CPOE are not always used, as they are viewed as too slow to operate efficiently.
To change these numbers, Clancy said AHRQ is spending about $166 million to help fund more than 125 health IT projects and demonstrations "with a strong focus on rural settings" in 43 states. This research, she said, assists in learning what approaches work and which don't.
"We need to know what doesn't work," Clancy said. "It's not so much just the hardware and software. If it was, it would be easy."
Implementing IT requires changing behavior, Clancy explained, and that's also an area that needs to be researched. In addition to a lack of research in general, she said IT is further hampered by the fact that most studies are coming from the same four sources: the Veterans Affairs Department, the Harvard Medical School-affiliated Partners HealthCare, Intermountain Healthcare in Salt Lake City and the Indiana University School of Medicine-affiliated Regenstrief Institute in Indianapolis.
Despite this lack of resources and the failure of Congress to pass legislation promoting HIT adoption, Clancy said the subject is still a hot topic in Washington. "If I stood on the metro platform and said health IT,' within three seconds, I'd have a crowd around me."
The health IT industry needs standardization and interoperability, Clancy said, but "probably the most important issue here is privacy," and patients need to be allowed to opt out of data-sharing arrangements. Patients must be "allowed to say no if that's what they want."
"Patients can see all too clearly that we could do a better job of managing medical information," she said.