INFORMATION TECHNOLOGY AND LONG TERM CARE

Information Technology and Long Term Care

Information Technology and Long Term Care

Introduction

Three years ago, president bush issued an executive order establishing the position of National Health Information Technology Coordinator in the U.S. Department of Health and Human Services. The charge was to lead a "nationwide implementation of an interoperable health information technology infrastructure [including adoption of electronic health record systems] to improve the quality and efficiency of health care" by 2014.

What have we learned since 2004? First, provider experiences shed light on the gap between the promise of health information technology (HIT) to improve health care and the realities of execution. For example, HIT adoption by hospitals and physician practices has been slower than expected.

Approximately 24 percent of physicians are using electronic health records (EHRs) and 5 percent of hospitals are using computerized physician order entry (CPOE). Second, strong evidence showing the impact of HIT on quality and costs is limited. Third, while experts agree that HIT is critical to transforming the health care delivery system, there is growing recognition that HIT is only one component of an improvement strategy. HIT provides the information capacity and tools to accomplish a variety of strategies (such as improving clinical decision-making, implementing a community-based chronic care model, conducting effective multidisciplinary team meetings, and enhancing process and outcome management). 5, 6 But more than information capacity and tools are needed to make these strategies a success.

A variety of individuals and organizations are attempting to further the cause of effective nationwide HIT implementation, including provider trade associations, health care researchers, consortiums of IT vendors, quality improvement organizations (QIOs), and providers. They are building on the HIT business case, looking into barriers and challenges from the provider perspective, and developing practical tools to support effective implementation.

Background of Healthcare Information Technology (HIT) and Long Term Care

Where does long term care fit in terms of HIT adoption and use? It is an important question because long term care providers care for the fastest-growing segment of the population and account for a high proportion of the health care dollars spent. The Congressional Budget Office reports that long term health care costs will reach $207 billion a year by 2020, and $346 billion a year by 2040. But providers of long term care have lagged behind physicians and hospitals in adoption of HIT. A recent U.S. Department of Health and Human Services Assistant Secretary for Planning and Evaluation (ASPE) report identified the "lack of robust evidence on HIT costs and benefits is especially conspicuous in the post acute care and long term care environments.”

The Agency for Healthcare Research and Quality has funded several grants related to HIT adoption and impact on quality and safety in long term care.0 Bills were introduced in the U.S.

House and Senate in July 2006 to establish a national consortium to study the impact of technology on the health care of an aging population.

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