A report from the National Research Council says efforts aimed at the nationwide deployment of HIT will not be sufficient to achieve medical leaders' vision of healthcare in the 21st Century and may even set back the cause.
The report, based partially on site visits to eight U.S. medical centers that are considered leaders in the field of healthcare IT, concludes that greater emphasis should be placed on IT that provides healthcare workers and patients with cognitive support, such as assistance in decision-making and problem-solving.
In 2001, the Institute of Medicine laid out a vision of 21st Century healthcare that involves care that is safe, effective, patient-centered, timely, efficient and equitable. Many aspects involve IT, such as having access to comprehensive data on patients, tools to integrate evidence into practice and the ability to highlight problems as they arise.
The eight medical centers concluded that the IT systems fell short of what is needed to realize the IOM's vision.
Their findings describe difficulties with data sharing and integration, deployment of new IT capabilities and large-scale data management. They found that current healthcare IT systems offer little cognitive support and clinicians spend a great deal of time sifting through large amounts of raw data (such as lab and other test results) and integrating it with their medical knowledge to form a whole picture of the patient.
Many care providers told the committee that data entered into their IT systems is used mainly to comply with regulations or to defend against lawsuits, rather than to improve care.
The report identifies several principles for improving healthcare IT. In the short term, it says, government, healthcare providers and healthcare IT vendors should embrace measurable improvements in quality of care as the driving rationale for adopting healthcare IT and should avoid programs that focus on adoption of specific clinical applications.
In the long term, the report says, success will depend upon accelerating interdisciplinary research in biomedical informatics, computer science, social science and healthcare engineering.
The eight medical centers visited were the University of Pittsburgh Medical Center; the Veterans Affairs Medical Center in Washington, D.C.; HCA TriStar and Vanderbilt University Medical Center, both in Nashville, Tenn.; Partners HealthCare System in Boston; Intermountain Healthcare in Salt Lake City; and the University of California-San Francisco Medical Center and Palo Alto Medical Foundation in California.
