Health information technology (HIT) is changing the delivery of health care. The federal government has spent billions of dollars to assist physicians and hospitals use HIT to improve outcomes. and a recent one found that HIT also has positive financial benefits for providers, consumers, and the entire health care system.
The authors reviewed the literature for articles that discussed HIT applications and financial outcomes. The review focused on electronic health records (EHRs), computerized physician order entry (CPOE), clinical decision support (CDS), and health information exchange (HIE) and included studies set in the United States that measured financial effect as a primary outcome. The resulting 57 articles were analyzed according to clinical setting, HIT application, study design, financial outcomes, and stakeholders affected.
Most of the studies involved outpatient settings (53%), while inpatient and emergency departments were also represented (30% and 9%, respectively). Studies of EHRs and CPOE/CDS were more common (46% and 42%, respectively) than those looking at HIE (9%). The majority of the studies had experimental or observational designs (60%) as opposed to case studies (19%) and models or projections (21%).
Seventy-five percent of the studies reported financial benefits across care settings and applications, with ten articles (18%) showing mixed or neutral effect and four (7%) demonstrating negative outcomes. Positive financial outcomes were measured through cost savings and revenue. The most widely cited mechanism for savings was on administrative goods/personnel, with additional savings on pharmaceuticals associated with CPOE/CDS applications, billing-coding, adverse drug events, diagnostic tests, clinical personnel and chronic diseases. In the included studies, providers reaped the most benefit, with 74% of the articles reporting financial benefits to them, followed by payers (28%), society (12%), and consumers (2%).
The authors concluded that more research into the financial effects of health information technology is needed. They highlighted the paucity of data on the costs of the initial HIT investment and the need for scientifically rigorous study designs with more comprehensive variables identified in future studies.
With increasing investments in HIT on the horizon, this article is timely and suggests that these initiatives will benefit stakeholders in the long term. As recommended by the authors, researchers should include HIT’s financial effects in their study designs since this information is critical to policy decisions that impact long-term HIT funding and sustainability. A broader focus on financial impact to consumers and the system as a whole is needed to define the most appropriate mechanisms for investment.
The thought of improved future cost savings and revenues incentivizes providers to adopt and use HIT. However, it is important to note the lack of data around the initial HIT investment, which may pose a barrier to adoption for some providers – especially those in small, rural, or underserved communities that lack the resources to initiate the transition.
by Megan Douglas, JD