Tuesday, September 22, 2009

Health IT Leadership

The Information Technology and Innovation Foundation (ITIF) released a report providing a detailed analysis of the countries that are leading in the use of information technology (IT) in health care, the factors that have led to their success, and the lessons that can be learned by other nations, including the United States, to drive health IT adoption. The report identifies elements contributing to success with health IT, including strong national-level leadership, the use of incentives and mandates, and the deployment of shared IT infrastructure in the health-care sector, and recommends strategies for policymakers to jumpstart progress on health IT adoption.

Better utilization of IT is one area of healthcare reform that has bipartisan support. Yet, although some countries have made dramatic progress in developing and implementing advanced health IT systems, the United States has struggled to make progress and is far behind international best practices. The United States has issued mandates for health IT only in a few cases for limited technical changes rather than as a push for broad reform, according to the report.

Daniel Castro, author of the report, said he viewed adoption of e-prescribing in this country as one of the core technologies of a national health IT system. He also stressed the need for adoption of Electronic Health Record (EHR) systems. "Countries like Denmark, Finland and Sweden demonstrate that widespread use of mature technologies like electronic health records improve the efficiency and effectiveness of health care," Castro, ITIF senior analyst said. "Policymakers in the United States should heed the lessons learned by the leaders. This isn't high school -- it's okay to copy from your neighbors."

For example, all primary care physicians in Sweden use electronic health records, while the rate is 99 percent in Finland and 95 percent in Denmark. Only 28 percent of primary care physicians in the United States use EHRs.

Although the United States is following a decentralized approach to the adoption of health IT, the foundation recommended policymakers support the development of a common infrastructure for routine tasks, such as a system for electronic patient authentications.

The key factors that have led to success in other countries discussed in this report are:

  • National leadership to promote health IT
  • Health care system organization and financing
  • Financial incentives for health IT
  • Government mandates to spur health IT
  • Size of a country’s population
  • Structural issues in the health care sector
  • Societal and cultural factors related to health IT
  • Privacy issues related to health IT systems
  • Policies to support telehealth
  • Common health IT infrastructure
  • Robust standards to support health IT
  • Use of unique patient identifiers

Further actions for policymakers to spur use and maximize benefits of health IT include the following:

  • Provide strong national-level leadership on health IT
  • Provide sufficient funding for health IT adoption
  • Build and share tools for health IT
  • Encourage the creation of health record data banks
  • Encourage personal health records with data sharing
  • Address legitimate privacy concerns
  • Eliminate barriers to health IT adoption
  • Leverage federal resources to support health IT initiatives
  • Encourage "in silico" health research
  • Collaborate and partner with all stakeholders

It is well worth the time to review the entire report.

The Information Technology and Innovation Foundation is a non-profit, 501(c)(3), non-partisan public policy think tank committed to articulating and advancing a pro-productivity, pro-innovation and pro-technology public policy agenda internationally, in Washington and in the states.