The New England Journal of Medicine recently published two perspective articles that examine health IT-related productivity gains and limitations in the electronic health record market. Summaries of the perspective pieces are provided below.
Perspective Piece on Health IT and Productivity
In one perspective article, researchers from RAND Corporation wrote that existing measurement tools have a limited ability to evaluate productivity gains resulting from the use of health IT, Healthcare IT News reports.
The perspective article states that a recent study found that less than 2% of ambulatory performance metrics are suitable to measure how computerization affects health care.
Other performance measures also are unable to capture improvements resulting from health IT use, the researchers found. For example, health care providers who provide medical advice via email instead of office visits might appear to be less productive based on existing health care performance measures, even if they are delivering care in a more convenient and efficient way.
For health IT to lead to productivity gains, health care professionals should do more than simply computerize their paper-based processes, the perspective article stated. It recommended that health care providers use health IT to support teamwork, care coordination and interactive patient portals.
Spencer Jones -- lead author of the article and an information scientist at RAND -- said, "As seen previously in manufacturing and other industries, the benefits of computerization in health care may only become evident over time as the delivery of health care is reengineered" (Manos, Healthcare IT News, 6/13).
Perspective Piece on EHR Innovation
A separate perspective article published in the New England Journal of Medicine argued that the current state of the electronic health record market might be stifling innovation.
Kenneth Mandl and Isaac Kohane -- both from the Center for Biomedical Informatics at Harvard Medical School in Boston -- wrote that "most (contemporary) EHR vendors not only have failed to innovate but don't even embrace existing modular architectures with interfaces that allow extension of product capabilities, innovative uses of data and interoperation with other software."
The authors wrote that there currently are more than 700 vendors that produce about 1,750 different certified EHR products. However, they noted that the majority of the EHR products cannot communicate with each other, which is not beneficial to patients or physicians.
The authors wrote, "Furthermore, despite this sprawl, a few companies controlling much of the market retain entrenched in 'legacy' approaches, threatening other vendors' viability."
They added that a healthy EHR market would encourage the development of innovative tools to improve communication and patient engagement (Byers, CMIO, 6/13).