Complex IT challenges will hinder online healthcare move

President-Elect Barack Obama has made no secret that his administration intends to rapidly computerize health care records in an effort to reduce costs and errors.  But the move to speed online medical record management and the administration of those systems is complex and could overburden medical IT staffs if not handled correctly.

The Government Accountability Office this week offered up a report on federal IT health initiatives and said: "Achieving widespread adoption and implementation of health IT has proven challenging, and the best way to accomplish this transition remains subject to much debate."

According to the Department of Health and Human Services (HHS), only a small number of U.S. health care providers have fully adopted health IT due to significant financial, technical, cultural, and legal barriers, such as a lack of access to capital, a lack of data standards, and resistance from health care providers, the report stated.

The GAO said that any transition to online record needs to address the following key issues:

  • Establish a foundation of clearly defined health IT standards that are agreed upon by all important stakeholders. Developing, coordinating, and agreeing on standards are crucial for allowing health IT systems to work together and to provide the right people access to the information they need: for example, technology standards must be agreed on (such as file types and interchange systems), and a host of content issues must also be addressed (one example is the need for consistent medical terminology). Although important steps have been taken, additional effort is needed to define, adopt, and implement such standards to promote data quality and consistency, system interoperability (that is, the ability of automated systems to share and use information), and information protection.
  • Define comprehensive plans that are grounded in results-oriented milestones and measures. Using interoperable health IT to improve the quality and efficiency of health care is a complex goal that involves a range of stakeholders, various technologies, and numerous activities taking place over an expanse of time, and it is important that these activities be guided by comprehensive plans that include milestones and performance measures.

Implement an approach to protection of personal privacy that encourages public acceptance of health IT. A robust approach to privacy protection is essential to establish the high degree of public confidence and trust needed to encourage widespread adoption of health IT and particularly electronic medical records. Health IT programs and applications need to address key privacy principles (for example, the access principle, which establishes the right of individuals to review certain personal health information). At the same time, they need to overcome key challenges (for example, those related to variations in states' privacy laws). Unless these principles and challenges are adequately addressed, there is reduced assurance that privacy protection measures will be consistently built into health IT programs and applications, and public acceptance of health IT may be put at risk.

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