Optimizing Health IT to Improve Health System Performance

A Work in Progress

Published in: Healthcare, Volume 8, Issue 4 (December 2020). doi: 10.1016/j.hjdsi.2020.100483

Posted on RAND.org on December 04, 2020

by Robert S. Rudin, Shira H. Fischer, Cheryl L. Damberg, Yunfeng Shi, Paul G. Shekelle, Lea Xenakis, Dmitry Khodyakov, M. Susan Ridgely

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Despite significant investments in health information technology (IT), the technology has not yielded the intended performance effects or transformational change. We describe activities that health systems are pursuing to better leverage health IT to improve performance.


We conducted semi-structured telephone interviews with C-suite executives from 24 U.S. health systems in four states during 2017–2019 and analyzed the data using a qualitative thematic approach.


Health systems reported two broad categories of activities: laying the foundation to improve performance with IT and using IT to improve performance. Within these categories, health systems were engaged in similar activities but varied greatly in their progress. The most substantial effort was devoted to the first category, which enabled rather than directly improved performance, and included consolidating to a single electronic health record (EHR) platform and common data across the health system, standardizing data elements, and standardizing care processes before using the EHR to implement them. Only after accomplishing such foundational activities were health systems able to focus on using the technology to improve performance through activities such as using data and analytics to monitor and provide feedback, improving uptake of evidence-based medicine, addressing variation and overuse, improving system-wide prevention and population health management, and making care more convenient.

Conclusions and implications

Leveraging IT to improve performance requires significant and sustained effort by health systems, in addition to significant investments in hardware and software. To accelerate change, better mechanisms for creating and disseminating best practices and providing advanced technical assistance are needed.

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