Community health care providers will need to find their own best paths to implementing HIT, according to a joint report by a health care consulting firm and non-profit group. But the report also says that financial incentives will be key to successful adoption.
A committee created by the U.S. Institute of Medicine identified health information technology as one of four forces critical to improving health care. But the U.S. Agency for Health Care Research and Quality (AHRQ) estimates that fewer than 10 percent of U.S. facilities have adopted "comprehensive" HIT. "Physicians, hospitals and other health care facilities have lagged behind most industries in their adoption of HIT systems. Reasons for this paucity of investment in HIT include misaligned financial incentives, high cost of investing in HIT systems, current evidence on HIT is limited to a few sites with homegrown legacy systems, limited data that HIT improves important outcomes, potentially disruptive effects on clinical workflow, cultural barriers and competing priorities."
More communities are hoping to launch health IT and health information exchange programs, according to one of the reports authors, the Foundation for eHealth Initiative, which last year received funding applications from 134 communities for such programs. Hundreds of organizations likely will try to get funding from a $31 million grant program established by the AHRQ.
But even with funding to help get an HIT system started, health care workers often need to be pushed to use the system as intended. The report identified four kinds of financial incentives that seem to be working but emphasized that the best strategy will vary by community.
One of the most common programs rewards clinicians and other providers with bonuses or other additional payments. Yet another creates an online consultation service for which health care providers can be reimbursed. The least-used incentive withholds some reimbursement for provider services until HIT is adopted.
Another approach, which is becoming more popular, encourages patients to use clinicians who have adopted HIT. Patients who use these providers have lower copayments or deductibles.
Other financial rewards described in the report include those outside health care payments, such as discounts for medical malpractice insurance, tax credits, and collaboration between IT vendors and health care providers.
The eHealth Initiative previously had launched a Web site where communities could get and share information about moving from paper-based record-keeping to electronic health records and about creating ways to provide access to information across institutions.
The report, titled "Financial Incentives: Innovative Payment for Health Information Technology," was co-authored by Health Strategies, a policy think tank, in Washington.
The full report can be found here.
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