What HIT Is Now and What it Needs to Be

Health information technologies (HIT) are improving, but there is still a huge gap between what HIT needs to be and what HIT is now. Only by closing this gap can HIT deliver what’s needed.

What it Needs to Be

As the USA struggles to deal with the healthcare crisis, mandates for change — such as the National Health Information Infrastructure (NHII) initiative — focus on the use of HIT to help increase healthcare effectiveness and safety, and reduce errors and costs, by:

• Deploying decision support tools with guidelines and research results


• Fostering collaboration and accelerating diffusion of knowledge


• Improving use of resources
• Increasing workflow efficiencies
• Reducing variability in care quality and access


• Advancing the consumer role
• Strengthening privacy and data protection
• Promoting public health and preparedness.

Achieving these objectives requires changes in healthcare policies and practices, as well as interoperable HIT that:

• Helps people know the safest and most cost-effective ways to care for each patient and deliver that care in a coordinated manner across the entire healthcare continuum with minimal error and omissions (see Consumer-Centered Care).


• Helps people understand each patient’s health problems and needs in fine, clear detail, to support accurate diagnostic and treatment prescription decisions (see Personalized Care).


• Helps people create and use evidence-based practice guidelines.
  Helps people know how to prevent illness and promote wellness for each person, and deliver such wellness/prevention programs.


• Promotes consumer/patient participation through increased knowledge and decision-support, which benefits them by increasing their ability to select the right providers and health plans, prevent illness/complications/accidents by focusing on self-care and wellness, and reduce complications of chronic disease by complying with plans of care.


• Promotes provider participation through increased knowledge, decision-support, and workflow efficiencies, which benefits them by increasing their ability to deliver more cost-effective treatment and increase patient safety (reduced errors and omissions).


• Promotes payer participation through increased knowledge, decision-support, and workflow efficiencies, which benefits them by increasing their ability to contain costs and take advantage of new business opportunities.


• Promotes purchaser participation through delivery of more cost-effective care to employees, which benefits them by reducing healthcare expenditures, absences, and turnover, as well as improvements on-the-job productivity.


• Enables collaborative networks to improve healthcare quality by helping them;
  
  • Perform clinical research in the field and lab through streamlined collection, sharing, and analysis of large quantities of diverse clinical outcomes data
  
  
  • Build evolving health science knowledgebases based on the clinical research and transform this knowledge into evidence-based practice guidelines
  
  
  • Disseminate, implement, and evolve the guidelines
  
  
  • Communicate easily and efficiently to share observations and lessons learned, handle disputes, and help run collaborative organizations.
  
  
  
  
• Protects populations by offering an efficient and effective way to obtain, transmit, and analyze biosurveillance and post-market surveillance data and by assisting first responders in the event of a wide-spread emergency (e.g., bioterrorism, epidemic).


• Helps utilize resources more efficiently.
• Helps people transfer data and information in a shared environment.


• Helps people use scaleable, integrated software applications.

What HIT is Now

Efforts these days focus on the most basic functional level of HIT, i.e., the development of interoperable architectures and the use of applications for inputting, validating, storing, securing, and exchanging basic patient data. Current HIT also offers some decision-support through reminders (e.g., of follow-up appointments, inoculations, etc.) and alerts via medication prescription checks, and streamline certain workflows. All this is a necessary first step, but it is grossly insufficient.

Does anyone disagree?

In my next post, I define the HIT gap and what can be done to bridge it.