Ways of assessing the state of health IT adoption

Unlike many industries that have already broadly adopted information technology (IT) as an essential ingredient of day-to-day business, the healthcare industry’s use of IT is like “a late bloom of a tardy child,” said Molly J. Coye, MD, MDH, CEO and founder, HealthTech, a non-profit research and education organization that develops objective technology forecasts for healthcare. Coye spoke this week at the Health Information Technology (HIT) Symposium at MIT in Boston, Mass., during a panel discussion that looked at the past and future of health IT in the United States.

She said that the healthcare field has a history of being late in adapting scientific advances from other fields. The trouble we have now is determining exactly where we are in the adoption process. Hype regarding health IT peaked awhile ago, and then reality set in, but the hope is that we will now shift into a more realistic and productive phase of adoption, Coye said.
But again, how do you determine where the industry is now? One approach was taken by a study Coye highlighted that was conducted in California in 2004 which looked at the healthcare consumer experiences of 34 million state residents. Through this, the study hoped to assess how technology was shaping healthcare.

 The study, dubbed the Structured inquiry of California health care leaders and organized by HealthTech, found that in 2004:

• 10 percent of healthcare consumers participated in online appointment scheduling;
• 10 percent of healthcare consumers participated in online appointment scheduling;
• 20 percent in online pharmacy refills;
• 40 percent had used the internet for health plan enrollment;
• 5 percent had communicated with a physician via email;
• Another 5 percent had paid medical bills online;
• 10 percent had participated in online customized education; and
• 5 percent had created a personal health record online.  

Another approach is to look at the clinical use side of the picture to determine how much providers are using the technology. Coye provided no numbers in this case, but did provide a list of the key health IT priority groupings for possible adoption assessment. These groupings include e-Prescribing, EHR (electronic health records), PHR (personal health record), community HIE (health information exchange), integration with clinical devices, and integration of clinical care.
Regarding the integration of clinical devices, the technology must produce information through remote monitoring, for example, that could be included in considering care. It must go beyond just making a physician’s records electronic, Coye said.

Beyond technology, certain key enablers of health IT adoption should also be tracked, Coye said, and these include standards development, pay for performance, security and confidentiality, development of technology, and development of business models, among others.