The Value of Health Information Technology

Filling the Knowledge Gap

Published in: The American Journal of Managed Care, v. 20, Special Issue No. 17, 2014, p. eSP1-eSP8

Posted on RAND.org on February 05, 2015

by Robert S. Rudin, Spencer S. Jones, Paul G. Shekelle, Richard Hillestad, Emmett B. Keeler

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Research Questions

  1. How do studies define and measure the value of health information technology (HIT)?
  2. How can we improve the way that we evaluate HIT?

Despite rapid growth in the rate of adoption of health information technology (IT), and in the volume of evaluation studies, the existing knowledge base for the value of health IT is not advancing at a similar rate. Most evaluation articles are limited in that they use incomplete measures of value and fail to report the important contextual and implementation characteristics that would allow for an adequate understanding of how the study results were achieved. To address these deficiencies, we present a conceptual framework for measuring health IT value and we propose a checklist of characteristics that should be considered in health IT evaluation studies. The framework consists of 3 key principles: 1) value includes both costs and benefits; 2) value accrues over time; and 3) value depends on which stakeholder's perspective is used. Through examples, we show how these principles can be used to guide and improve health IT evaluation studies. The checklist includes a list of contextual and implementation characteristics that are important for interpretation of results. These improvements will make future studies more useful for policy makers and more relevant to the current needs of the healthcare system.

Key Findings

Current studies do a poor job of describing the value of HIT interventions, both in terms of costs and benefits, making it difficult to pinpoint when and how HIT works best.

  • Few studies report on both the costs and benefits of HIT.
  • Most studies have a relatively short time horizon (1-3 years) and do not capture the potential long-term benefits of HIT.
  • In many cases, studies do not specify whether they are measuring value from the patient's, physician's, or payer's perspective.
  • Few studies explain how a specific technology works, let alone how it was implemented, and most don't report basic contextual information such as what payment system was used.

Recommendation

Studies need to report on both the costs and benefits of HIT, use longer time horizons, consider the perspectives of multiple stakeholders, and describe implementation details and contextual variables.

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