Health Information Technology
Health informatics—the application of computing and communications technology to health care— offers potentially big payoffs for health care reform by making it possible to store, share, transmit, and analyze vast amounts of information. The vision is that such systems will help improve the quality and efficiency of health care, reduce medical errors and ethnic/racial disparities, lower costs, and open up new ways of examining health issues. As such, the potential benefits of health informatics are of interest to health care providers, insurers, consumers, health researchers, and public health officials. Health information technology (HIT), which encompasses electronic medical records, decision support systems, and computerized physician order entry for medications, is becoming increasingly important in the health informatics arena. RAND’s current HIT studies are highlighted below.
Profiles of Current Research
Advancing Clinical Decision Support
A project to accelerate successful implementation and effective use of computer-based clinical decision support interventions to facilitate evidence-based clinical practice and meaningful use of HIT. Contacts: Douglas Bell, MD, PhD (Douglas_Bell@rand.org) or Cheryl Damberg, PhD (Cheryl_Damberg@rand.org)
E-Health Records and Performance Measurement
A joint project with the Massachusetts eHealth Collaborative to evaluate the use of electronic health records for measuring the quality of ambulatory care in a community-wide setting. Contact: Eric Schneider, MD (Eric_Schneider@rand.org)
HIT Implementation Guide
A project to produce a guide that will help a diverse range of provider organizations (inpatient and ambulatory) address the unintended consequences of their HIT implementation. Contact: Shinyi Wu, PhD (Shinyi_Wu@rand.org)
Toolsets for E-Prescribing
Development of toolsets, one for health care providers and one for pharmacies, to help them adopt e-prescribing systems and use them effectively. Contact: Douglas Bell, MD, PhD (Douglas_Bell@rand.org)
Highlights of Recent Studies
Consumer-controlled personal health management systems: will they help to control health care costs?
Consumer-controlled personal health management systems (HMSs) are a class of tools that promote healthy lifestyle choices and provide health data to individuals, as well as aid in decision support. How will they be used to reduce health care costs, and to what effect?
Electronic Health Records Are Associated with Higher Quality in Primary Care Practices
This assessment of 13 recommended practice investments for primary care found that among all investigated practice capabilities, electronic health records were associated with the greatest magnitude of higher performance on the widest range of quality measures. While quality differences were modest in size, the study is one of the first to demonstrate a link between use of electronic health records in community- based primary care practices and higher-quality care.
Identity Crisis? Approaches to Patient Identification in a National Health Information Network
A unique patient identifier (UPI) would enable physicians, hospitals, and other authorized users to electronically share clinical and administrative records more efficiently, and it could serve as a building block for the new national health information network (NHIN). However, development of a UPI has been sidetracked by privacy concerns, leading to reliance on alternative statistical matching techniques to identify and access patient information. This study found that a UPI approach could strengthen patient privacy and security and that continuing a de facto endorsement of statistical matching as the only approach to linking patients with their health care records is likely to inhibit the effective development of the NHIN.
A National Health Information Network—What Are the Real Privacy Issues?
Unique patient identifiers (UPIs), proposed as part of a national health information network (NHIN) to identify and match patients' electronic medical records, may enhance rather than degrade privacy. More important, the controversy over UPIs distracts from the key privacy issues connected with an NHIN: Namely, the need to strengthen Health Insurance Portability and Accountability Act (HIPAA) privacy rules and to reconcile current state laws on health information privacy.
Health Information Technology: Can HIT Lower Costs and Improve Quality?
Properly implemented and widely adopted, HIT would save money and significantly improve health care quality. Annual savings from efficiency alone could be $77 billion or more. Obstacles include market disincentives: Generally, those who pay for HIT do not receive the related savings.
Electronic Prescribing Systems: Making It Safer to Take Your Medicine?
Electronic prescribing systems may greatly reduce medication errors, thereby maximizing patient safety and health, but currently used systems vary widely in their features and capabilities and may not produce the best results for patient safety and health.
Related Websites
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