Friday, April 04, 2014

The RAND Corporation Reviews Health IT Studies For ONC. A Very Important Study Indeed.

This appeared during the last few weeks.
Health IT Literature Review Report and Interactive Data Visualization on the Health IT Dashboard!
ONC recently updated its Health IT Dashboard with the results of a comprehensive literature of the impacts of health IT titled: Health Information Technology: An Updated Systematic Review with a Focus on Meaningful Use Functionalities. The literature review updates previous systematic reviews with the new peer review literature published during the 2010 to 2013 time frame.
The literature review results include findings that the majority of new studies indicate that health IT enabled significant gains in health care quality, but efficiency and safety were still the subjects of relatively little research. In addition, this report has a complementary interactive data visualization that allows users to see the value of health IT across these outcomes. The report and data visualization are just one of many examples of what ONC has been doing to show the value of health IT and make data come alive.
Download the full report [PDF — 2.2 MB] from HealthIT.gov, or dig deeper into the literature with ONC's interactive data visualization. With the data visualization you can:
  • Read about the effect of health IT on outcomes
  • Use a clickable interactive tree map that shows what Meaningful Use health IT functionalities have positive or negative impacts on healthcare outcomes.
  • Browse through a sortable and interactive table of 236 new health IT studies to explore what the new research evidence shows regarding the relationship between health IT and quality, safety, and efficiency.
There is a fair bit of commentary on this report.
See here

Health IT benefits outweigh the negative, report shows

By Erin McCann, Contributing Editor
A new study conducted by RAND Corporation for the Office of the National Coordinator for Health IT has found that the benefits of health IT outweigh any negative or neutral effects of their use.
The January study examined 236 health IT studies from 2010 to 2013. It found that 77 percent of them reported either positive or mixed-positive outcomes -- meaning there existed at least one negative association between health IT and the care metric, but the original authors concluded the benefits outweighed negative or neutral effects.
However, nearly 20 percent of the studies on health IT's efficiency outcomes yielded negative results, and only 45 percent saw overwhelmingly positive outcomes. Researchers described efficiency as including costs, utilization and timelines.
Drilling down further into efficiency, CDS alerts and reminders were proven to be most ineffective, with some 43 percent having reported negative results.
"Cost effects ranged from a 75 percent decrease to a 69 percent increase in the targeted costs; however, many of the studies clustered in the range of six percent to 12 percent increases in the targeted costs," RAND officials wrote in the report. "These findings suggest that layering technology on the existing payment system may not result in lower costs."
As for patient safety, researchers also found mixed results. For instance, 17 percent of the studies assessing health IT's impact on safety had produced negative outcomes, and 67 percent had reported all positive results.
"While the great majority of studies reported positive outcomes for process quality measures, not all studies did so, and most studies lacked sufficient detail to determine which factors may have led to the lack of benefit found," officials wrote.
The report underscored quality as the metric most improved by implementing health information technology, as the lion's share of studies, 58 percent, saw positive outcomes, and another 24 percent saw mixed-positive results.
When officials drilled down further into the data, they also found clinical decision support, computerized provider order entry and meaningful use all produced the most beneficial outcomes, at 66 percent, 64 percent and 63 percent positive respectively.
Contrastingly, electronic prescribing was the least able to prove its worth, as more than one-fourth of all studies reported negative outcomes.
Lots more here:
And here:

ONC publishes new review of health IT functionalities

March 5, 2014 | By Marla Durben Hirsch
More than three-fourths of studies on health IT have found that technology provides at least some positive impact on patient care, but the studies themselves need improvement, according to the Office of the National Coordinator for Health IT's new literature review, prepared by the RAND Corporation.
The 145-page report updates previous reviews on the effects of health IT on patient care. This is the first review to focus specifically on identifying and summarizing the evidence relating to the use of health IT outlined in the Meaningful Use regulations.
The review of literature, from January 2010 to August 2013, found that 77 percent of the studies meeting the eligibility criteria reported positive or mixed positive results; studies on safety and quality reported more positive results than those on electronic health record efficiencies.  The researchers also found that the effect of health IT was influenced by the particulars of the IT system used, the implementation process and the context in which the IT was implemented.
More here:
This is clearly the best aggregated research on health IT. Download the .pdf and have a read!
David.

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