Friday, July 19, 2013

This Is A Major Report Card On The Progress Of Health IT in The US. It’s Off And Rolling It Would Appear.

This appeared a few days ago:

RWJF sees 'unprecedented' IT growth

Posted on Jul 09, 2013
By Mike Miliard, Managing Editor
The HITECH Act has had its desired effect so far, according to the latest annual report from the Robert Wood Johnson Foundation, which finds heartening adoption levels of health IT across the board, from small physician practices to academic medical centers, over the past three years.
The study, “Health Information Technology in The United States: Driving Toward Delivery System Change, 2013," was co-authored by Mathematica Policy Research and the Harvard School of Public Health. It shows that in 2012, 44 percent of hospitals reported having a basic electronic health record system – up 17 percentage points from 2011.
Indeed, since 2010 – when providers started getting federal stimulus funds – the proportion of hospitals with at least a basic EHR system has nearly tripled, according to the RWJF report.
Physician practices, meanwhile, have also made substantial progress, with more than 38 percent reporting the adoption of basic EHR functionalities in 2012.
Of those providers who've made investments in IT, many have already made significant strides in putting it to work: some 42 percent of hospitals reported the implementation of all functionalities required to meet Stage 1 meaningful use this past year – up from 18.4 percent in 2011 and just 4.4 percent in 2010.
“Hospitals, physicians and other health care providers are clearly taking advantage of recent incentives to embrace the promise of technology,” said RWJF Senior Vice President John R. Lumpkin, MD, in a press statement. “It’s particularly encouraging to see that more doctors and hospitals are using electronic health records, which contribute to better care at the bedside."
Still, the study spotlights several areas where there's room for improvement. While U.S. physicians reported increased use of EHRs in 2012, the United States lags behind several other developed countries. In addition, researchers found room for improvement in using HIT to develop effective patient education tools that track progress and meaningfully engage patients.
"There is still a significant amount of work to be done to ensure that our health care system is as up-to-date as it can be," said Lumpkin. "These kinds of technologies can lead to safer, higher-quality care.”
The study suggests that, with EHRs now in place, more and more providers are using them as building blocks for bigger IT initiatives and broader partnerships across their communities.
More than a quarter (27 percent) of hospitals are now participating in health information exchange initiatives – up from 14 percent in 2010. As for ambulatory practices, just 10 percent participate in an HIE – but that's up from just 3 percent in 2010.
And that shared data is being put to strategic use, the RWJF report shows, with 33 percent of HIEs supporting accountable care organizations and 45 percent supporting patient-centered medical homes.
More here:
Access the full report here.
At the same time 3 papers were released by Health Affairs:
Operational Health Information Exchanges Show Substantial Growth, But Long-Term Funding Remains A Concern

By Julia Adler-Milstein, David W. Bates, and Ashish K. Jha

Adler-Milstein is with the University of Michigan in Ann Arbor; Bates is affiliated with Brigham and Women's Hospital in Boston; and Jha is at the Harvard School of Public Health in Boston.
To assess a key component of national progress in health IT adoption, the authors surveyed all US organizations that facilitated the exchange of clinical data between unaffiliated organizations in late 2012. They found that 30 percent of hospitals and 10 percent of ambulatory practices participated in one of 119 operational health information exchange efforts. That is more than double the early 2010 participation rate. Seventy-four percent of these health information exchange efforts identified developing a sustainable business model as a barrier to success. For 52 percent of these operational efforts, grants and contracts were the most substantial source of support. The authors concluded that there has been substantial growth in the number of providers adopting health IT; however, for progress to continue after HITECH funding runs out, policy makers must "help these efforts identify and implement sustainable business models."
Adoption Of Electronic Health Records Grows Rapidly, But Fewer Than Half Of US Hospitals Had At Least A Basic System In 2012

By Catherine M. DesRoches, Dustin Charles, Michael F. Furukawa, Maulik S. Joshi, Peter Kralovec, Farzad Mostashari, Chantal Worzala, and Ashish K. Jha

DesRoches is at Mathematica Policy Research in Cambridge, Mass; Charles, Furukawa, and Mostashari are affiliated with the Office of the National Coordinator for Health Information Technology at the US Department of Health and Human Services in Washington, D.C.; Joshi is with the Health Research and Educational Trust in Chicago; Kralovec is with the Health Forum in Chicago; Worzala is at the American Hospital Association in Washington; and Jha is with the Harvard School of Public Health in Boston.
To measure current hospital use of electronic health record (EHR) systems, the authors used data from the 2012 health IT supplement to the American Hospital Association's annual survey. According to that data, 44 percent of hospitals report having at least a basic EHR system. This represented a 17 percent increase from 2011 and a near-tripling of the 2010 adoption rate. The authors also found that large urban hospitals continued to outpace rural and nonteaching hospitals. Although 42.2 percent of all hospitals met all the stage 1 meaningful-use criteria, only 5.1 percent had advanced to stage 2. The authors concluded, "Although our findings demonstrate considerable progress on the whole, they suggest the need for a focus on hospitals still trailing behind, especially small and rural institutions. This will be especially important as stage 2 meaningful-use criteria become the rule, and positive incentives are replaced by penalties for noncompliance."

Office-Based Physicians Are Responding To Incentives And Assistance By Adopting And Using Electronic Health Records

By Chun-Ju Hsiao, Ashish K. Jha, Jennifer King, Vaishali Patel, Michael F. Furukawa, and Farzad Mostashari
Hsiao is with the Centers for Disease Control and Prevention's National Center for Health Statistics in Hyattsville, Maryland; Jha is with the Harvard School of Public Health in Boston; and King, Patel, Furukawa, and Mostashari are affiliated with the Office of the National Coordinator for Health Information Technology at the US Department of Health and Human Services in Washington, D.C.
Perhaps the most tangible success story of EHRs' expanded use can be told by office-based physicians. Using data from the 2010-12 National Ambulatory Medical Care Survey--Electronic Health Records Surveys, the authors found that the proportion of physicians using at least a basic EHR system increased from just 25 percent in 2010 to 40 percent last year. The highest relative increases occurred among physicians who had lower levels of adoption in the past: those who were older, in solo practices, or working at community health centers. The authors suggest that this adoption surge may have been partially due to the availability of financial incentives for providers treating Medicare and Medicaid patients. Their findings also show that EHR adoption rates for solo practitioners were less than half the adoption rates of physicians in practices with eleven physicians or more. "As providers become increasingly accountable for both costs and quality of care, having robust information systems that allow them to manage care more effectively and share information with their patients will be critical," the authors concluded.
As I read this I have to say that it does seem that real progress is being made.
Yet again the proof of the pudding will be in the eating in terms of seeing improved clinical and financial outcomes. I assume the measurement work is already underway. I really look forward to the results given the billions of dollars the US has spent.

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