While the United States faces different challenges than other nations that have gone digital–the United Kingdom, Canada, and Scandinavia all have nationalized health care–experts say that we still have lessons to learn from those program. The United Kingdom spent $13 billion on a highly criticized health-care transformation. One problem with that program was a lack of physician participation in the early stages. “They didn’t engage local physicians or governments,” says Halamka. So states with little existing health-care IT infrastructure may need extra help in setting up their programs, he says.
Physician education will also be paramount, says David Bates, chief of the Division of General Medicine at the Brigham and Women’s Hospital, in Boston. “It’s important to make sure that providers are using the system, and that we have approaches for finding people having difficulties,” he says. Bates notes, however, that the United Kingdom is doing something right: only three general practitioners there are not currently using electronic medical records.
A study published this week in the Archives of Internal Medicine suggests that broad adoption of IT systems may provide significant health benefits for patients. Researchers at the Johns Hopkins University School of Medicine, in Baltimore, rated clinical information technologies at 41 hospitals in Texas and compared those results with discharge information for more than 160,000 patients. Technologies recorded included electronic note taking, treatment records, test results, drugs orders, and decision-support systems that offer information concerning treatment options and drug interactions. The researchers found that hospitals that rated highly on automated note taking had a 15 percent decrease in the odds that a patient would die while hospitalized. Hospitals with highly rated decision-support systems also had 20 percent lower complication rates. Researchers found that electronic systems reduced costs by about $100 to $500 per admission.
The findings confirm that commercially available health-care IT programs can improve patient care in a diverse range of settings. Most previous studies have focused on just one or two institutions–mostly academic medical centers, which have often developed their own systems. “I think this study really helps justify the stimulus package,” says Bates.
The House of Representatives’ Committee on Ways and Means approved the health-care IT portion of the plan last week, and the House and Senate are now finalizing their versions of the broader stimulus bills. Congress hopes to bring a bill before the president by Presidents’ Day: February 16.