For all the billions of dollars that have been -- and continue to be -- spent on health IT upgrades, technology's impact on health care safety is mixed and has done little to mitigate health and hospital expenditures, according to a new report from the Rand Corp.
It was Rand, a global research and analysis group with offices in Pittsburgh, that also penned the oft-cited 2005 report that claimed "rapid adoption of health information technology could save the United States more than $81 billion annually" in health costs.
Health information technology could do so, the original report and proponents suggested, by improving quality of care, eliminating duplicative tests, getting rid of wasteful paper records and improving communication among providers and insurers.
But those savings and efficiencies have not materialized, according to the analysis published Jan. 11 in the medical journal Health Affairs.
One of the report's author's, Rand policy analysis chair Arthur L. Kellermann, said the 2005 report wasn't so much in error as the adoption of health IT hasn't been as uniform as expected.
"It's not that the concept is flawed or that IT is a bad idea," he said last week. "The 2005 report said this is what we could save, not what we would save."
The 2013 report -- "What It Will Take To Achieve The As-Yet-Unfulfilled Promises Of Health Information Technology," by Mr. Kellermann and Rand information scientist Spencer S. Jones -- said the disappointing performance of health IT over the last eight years is attributable to a few factors.
Those include: "sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and the failure of health care providers and institutions to re-engineer care processes to reap the full benefits of health IT" in a way that values quality of care over volume.
Unfortunately, Mr. Kellermann said, "We are still in a fee-for-service environment, a bill-more, do-more situation."
As for the medical records systems that are "neither interoperable nor easy to use," critics of forced health IT adoption -- largely doctors and the clinical staff that are using the systems -- have been making that complaint for years, saying the first generations of these systems are non-intuitive and create more work than they save.
In some cases, they have made it harder for doctors and nurses to do their jobs -- occasionally with fatal consequences. But clinics and hospitals often felt as if they had no choice but to install untested software and hardware, a "rush to adopt" driven in part by federal regulations that have allocated billions for health IT upgrades, and threaten to cut Medicare and Medicaid reimbursements starting in 2015 for hospitals and doctors that haven't adopted "meaningful" health IT systems.
New generations of health IT software should address the shortcomings built into the current generation of systems, Mr. Kellermann said.
"We're one of the last sectors of the economy to come to the game," he said. "We'll get there with health care, [but] we are a distance from there now."
As reported in the New York Times, Rand's 2005 report was paid for by a group of tech companies, including General Electric and Cerner Corp., "that have profited by developing and selling electronic records systems to hospitals and physician practices."
And they have profited handsomely. Cerner's revenue, according to the Times, "has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005."
Cerner, a health records firm based in Missouri, has worked on several projects with Pittsburgh health system UPMC, making UPMC one of Cerner's single largest clients.
Bill Toland: firstname.lastname@example.org or 412-263-2625.