The goal of health information technology (HIT) is to improve the availability of information to clinicians at the point of care. The two most significant components in the HIT infrastructure are electronic medical records (EMR) and health information exchange (HIE). Together, these technologies will be the major disrupts in the health care industry over the next five years. Most health care providers are already aware that they must have an EMR with HIE integration in order to achieve meaningful use, start an Accountable Care Organization, or participate in a medical home model; however, adoption remains low while resistance remains high.
While healthcare IT executives applaud the benefits that HIE can provide, such as improving the quality of clinical reporting and the coordination of care among physicians, the high costs of participating in an HIE is still an impediment. A recent study found that 41% of physicians consider high start-up costs and insufficient capital to support HIE as their major concerns. Additionally, 38% said they have annual budgets for HIE development of less than $1 million, while 21% have no budget at all.
There are several implementation issues with HIE integration as well. Currently, because there is not one single set of standards consistently implemented, a custom connection has to be developed from each EMR to each HIE. The development of the interface represents a significant expenditure of cost and time for all stakeholders, including physicians and vendors, which has been limiting both adoption of EMR and the usage of HIE services.
Regardless of the foregoing problems, we cannot deny the substantial albeit unforeseeable benefits on the EMR/HIE horizon, especially if we look at precedent-setting examples. HIE is the most significant transformational tool healthcare has seen since advanced imaging, and the benefits will lead to tremendous improvements in treatments and outcomes. Stakeholders will soon face a much bigger stick than competing in the market to answer the health care equivalent. Patients and physicians will demand more efficient information exchange through a multifaceted approach that will create unprecedented resource disruption and, ultimately, higher costs to the stakeholders that continue to lag behind.
At present, 90% of patient health information resides in private practices within any given community. This is a staggering number considering the fact that there is no efficient way to transition and coordinate care between health care providers. The gradual but steady adoption of EMRs is a step in the right direction for improved workflow and quality of patient care. The next step is for physicians to realize the value of being able to efficiently transition care and the information that is associated with this process. The idea of a fully functioning national HIE may seem farfetched, but then again, there are substantial grounds to continue its development.