Health Care Technology Not Quite There Yet


No one is doubting the potential of health information technology, including electronic medical records, to enhance patient care. Progress, however, is needed in many areas, according to a senior researcher with the Center for Studying Health System Change. The New England Journal of Medicine reports:

Health information technology (HIT) holds promise for facilitating vast improvements in care and, ultimately, in the health of Americans,1,2 but achieving that potential remains a daunting task. A recent article in the Los Angeles Times described the new phenomenon of hiring computer-savvy undergraduate “scribes” to take notes for physicians during patient encounters and enter the information into electronic health records (EHRs) — a practice that suggests how far we must go to develop EHRs that clinicians will embrace. Of course, the most highly trained professional in the room need not be the one to enter data into the computer, especially during an emergency, but the perceived need for scribes and providers’ experiences using EHRs3 raise important questions about both the efficiency of care processes and the usability of current EHRs.

Although EHRs laudably provide immediate access to patient data and electronic messaging functions, clinicians have been frustrated by the difficulty of using them to support care delivery and coordination.3 Transforming EHRs into effective clinical tools rather than a means of capturing information primarily for documentation and billing purposes will require progress on multiple fronts.

Clinical processes must evolve so as to improve care and be more responsive to patients’ needs, and HIT’s capabilities must evolve along with them. HIT has particular potential in such areas as coordination of care, workflow efficiency and use of teams, clinical decision support, and population health management — all areas offering glimpses of both the potential and the challenges associated with improved HIT use.

Few providers today, for example, can truly coordinate care — integrating care, in consultation with patients and their relatives and caregivers, across all of a patient’s conditions, needs, clinicians, and health care settings.2-4 Outpatient practices and inpatient facilities lack well-developed processes for exchanging information, both within their own walls and during care transitions. Poor care coordination negatively affects patients — particularly those with multiple chronic conditions who account for an overwhelming proportion of U.S. health care expenditures.

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