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American Academy of Family Physicians
Wednesday Jan 09, 2013

Health IT was supposed to save money. What happened?

You may have noticed that health care costs have continued to rise even as more physicians and hospitals are using technology designed to bring those costs down.

According to a new analysis by the RAND Corporation, annual U.S. health care expenditures are up $800 billion from seven years ago. It was in 2005 that RAND researchers predicted that health information technology (IT) would save the country $81 billion a year.

So what went wrong?

In the analysis, published in this month's Health Affairs, researchers say a lack of standardization and poor incorporation of health IT into the health care process has stymied many of its strengths.

"In our view, health IT's failure to quickly deliver on its promise is not due to its lack of potential but to shortcomings in the design and implementation of health IT systems," researchers Arthur L. Kellermann and Spencer S. Jones wrote.

The biggest problems facing health IT, the duo say, are the lack of interoperability between systems, essentially isolating patient records from outside providers that need them; the continued sluggish adoption of IT; poor user interfaces that end up hurting physician productivity; and an economic model still favoring inefficient fee-for-service reimbursement.

The fact that patients aren't the ultimate controllers of health care information doesn't help, either.

"The current generation of electronic health records functions less as 'ATM cards,' allowing a patient or provider to access needed health information anywhere at any time, than as 'frequent flier cards' intended to enforce brand loyalty to a particular health care system," the researchers wrote.

RAND said technology companies need to work with providers to make their systems easier to use and embrace attempts by the government and others to create standards that would allow different systems to communicate easily. Also, the systems need to give patients the ability to personally control their information and who it goes to.

But the researchers said that is only the beginning.

"Ultimately, there is only so much that the government and vendors can do," they wrote. "Providers must do their part by reengineering existing processes of care to take full advantage of the efficiencies offered by health IT. This revamping of health care delivery is unlikely to happen before payment models are realigned to favor value over volume."

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