JAMA study: HITECH Helped Promote EHR Use, but Usability Issues Remain

While the recent push to adopt health IT systems has helped to improve care and reduce costs, issues with usability and interoperability require further federal attention, according to a study published in the Journal of the American Medical Informatics Association, FierceHealthIT reports.

Study Details

For the study, University of Edinburgh researchers interviewed 47 U.S.-based health IT stakeholders (Hall, FierceHealthIT, 4/16). The researchers sought to determine whether health IT has helped to achieve the Institute for Healthcare Improvement's "triple aim," for health care. The triple aim includes:

  • Enhancing population health;
  • Improving patient care; and
  • Reducing health care costs (Gruessner, EHR Intelligence, 4/17).

The stakeholders interviewed included:

  • Government employees;
  • Health IT experts;
  • Health policy experts;
  • Patient advocates;
  • Payers;
  • Providers; and
  • Vendors (FierceHealthIT, 4/16).

Study Findings

The researchers found "a widely shared belief" that the HITECH Act spurred the adoption of a digital infrastructure that is being used to improve the quality of care while reducing costs.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments (Sheikh et al., JAMIA, 4/16).

However, there was concern among physicians regarding the usability of:

  • Electronic health records; and
  • Computerized decision-support systems.

Physicians said the systems were immature technologies that had been written based on old code designed for hospital billing. In addition, physicians said they considered currently used EHR technology to be inadequate in:

  • Supporting multidisciplinary teamwork; and
  • Incorporating quality measurement into care delivery.

Both physicians and vendors said meaningful use requirements present a distraction from more development and clinical priorities (FierceHealthIT, 4/16).

In addition, many respondents reported that it is important to move toward value-based care driven by data and high levels of care, and away from fee-for service payment models (EHR Intelligence, 4/17).

Policy Recommendations

During the interviews, many respondents suggested that CMS and the Office of the National Coordinator for Health IT require vendors to open their application program interfaces and encourage collaboration with:

  • Small vendors; and
  • The medical informatics community.

The two areas that were considered the biggest policy issues were:

  • Further financial reform; and
  • Interoperability (FierceHealthIT, 4/16).
Source: iHealthBeat, Monday, April 20, 2015

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