More metrics needed to show true return on health IT investment

With a hefty national deficit and climbing healthcare costs in the U.S., many are looking at innovations in health IT to help rein in costs and improve care.

A recent editorial, written by Thomas H. Payne, MD, of University of Washington Medicine in Seattle, and colleagues, in the March issue of the Journal of the American Medical Infomatics Association put a microscope on the relationship between health IT and economics. The editorial culminated from research conducted at the 2011 winter symposium of the American College of Medical Informatics.

As the U.S. government pours nearly $30 billion into health IT through the HITECH Act, the authors contended that there is insufficient publicly available evidence to assess whether the investment is making a difference. Moreover, they argued that an operational data model for healthcare organizations is needed to determine the economic impact of health IT. This model would include measurable variables at the local organizational level that can be aggregated on a national scale.

“To make an accurate assessment of the investment, we need to develop metrics that can be used across different health IT systems and different healthcare settings,” Payne wrote, later concluding that these metrics should not only look at inputs and investments, but outputs as well.

The article also recommended that the U.S. healthcare system follow the example of the U.K.’s National Institute for Health and Clinical Excellence, which is required to establish if the evidence base is sufficient in addition to formulating health IT policy.

While the authors said there is a dearth of evidence to definitively answer the question whether IT investment is lowering costs, the article referred to healthcare delivery organizations that are prioritizing IT as a way to cut costs and improve care. These approaches may translate into a new way forward on a national level, according to Payne.

Kaiser Permanente, for instance, reduced office visit rates by more than 25 percent and increased patient communication and satisfaction through its health IT practices. It had implemented an EHR tailored specifically to transform care and service delivery through improving quality outcomes, patient satisfaction and engagement, reducing unneeded services and inefficient processes.

The Geisinger Health System promotes financial incentives for quality and to reduce rework and readmission through health IT. Likewise Partners HealthCare harnesses IT to improve efficiency, safety and quality, and has rolled out EHRs for all providers and implemented computer provider order entry in all hospitals.

An analysis of the U.S. Department of Veteran Affairs’ significant health IT investments links it to reductions in unnecessary and redundant care, process efficiencies and improvements in care quality with an estimated yield of $3.09 billion in cumulative benefits after subtracting investment costs, by 2007, according to the article.

Health IT can potentially reduce spending by eliminating duplicate unnecessary costs, ineffective treatments, keeping patients out of hospitals or managing them at home and improving billing practices. But the authors contended that in addition to health value, the main contribution of health IT may be that it drives new healthcare delivery models that achieve a much greater value.

While the authors stressed that health IT is a vital enabler of system changes to help overcome rising healthcare costs and the national deficit, now is the time to develop effective models to determine whether it is paying off.