What is it?
HIE provides the capability to electronically move clinical information between disparate healthcare information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care.
Formal organizations are now emerging to provide both form and function for health information exchange efforts. These organizations (sometimes called “Regional Health Information Organizations,” or “RHIOs”) are ordinarily geographically-defined entities which develop and manage a set of contractual conventions and terms, arrange for the means of electronic exchange of information, and develop and maintain HIE standards. (Source: eHealth Initiative, Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations, August, 2005)
Fact: The U.S. healthcare system could improve care, as well as save $162 billion annually with widespread use of healthcare information technology. (Source: A two-year study by the RAND Corporation released September 14, 2005.
-> Saving lives: Broad use of computer physician order entry could reduce the 8 million medication errors that occur every year by two-thirds. In addition, online-enabled preventive care and chronic disease management programs offer savings by controlling acute episodes, prompting recommendations for preventive services, and reducing physician and hospital visits
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Thousands of Americans die each year as a result of medical errors caused primarily by systematic problems, and many more experience other unnecessary harms. The estimate from the Institute of Medicine (IOM) that between 44,000 and 98,000 people die from medical errors each year is widely cited.40 (Source: To err is human: Building a safer health system. Washington, DC: National Academy Press; 2000.)
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The Center for Information Technology Leadership (CITL) estimates that, of the 900 million outpatient visits in the U.S., 8.8 million are attributable to adverse drug events, 3 million of which are preventable, and 2.1 million ambulatory adverse drug events could be avoided. (Source: Walker J, Pan E, Johnston D, Milsten J, Bates D, Middleton B. The Value of Computerized Provider Order Entry in Ambulatory Settings. Boston (MA): Center for Information Technology Leadership; 2004.)
-> Saving healthcare dollars: The Office of the National Coordinator for Health Information Technology estimates that the annual savings attributable to widespread EHR adoption are likely to lie between 7.5 percent and 30 percent of annual healthcare spending.
- Studies in ambulatory care settings estimate that EHRs would save $112 billion per year (7.5 percent of healthcare spending), including $34 billion annually for in-office reduction and $78 billion annually from interoperability of those EHRs. (Source: Walker J, Pan E, Johnston D, Milsten J, Bates D, Middleton B. The Value of Health care Information Exchange and Interoperability. Boston (MA): Center for Information Technology Leadership; 2004.)
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Other recent research indicates that nearly 30 percent of healthcare spending in the United States is for treatments that may not improve health status, may be redundant, or may be inappropriate for the patient’s condition. (Sources: Fisher E, Wennberg D, Stuckel T, Gottlieb D, Lucas F, Pinder E. The implications of regional variations in Medicare spending, Part 1: The content, quality and accessibility of care. Annals of Internal Medicine 2003; 138:273-287; Fisher E, Wennberg D, Stuckel T, Gottlieb D, Lucas F, Pinder E. The implications of regional variations in Medicare Spending, Part 1: The content, quality and accessibility of care. Annals of Internal Medicine 2003; 138:273-287; Wennberg J, Fisher E, Skinner J. Geography and the Debate Over Medicare Reform. Health Affairs 2002; W96-W114; Wennberg J, Thomson P, Fisher E, Stukel T, Skinner J, French J, Sharp S, Bronner K. Use of hospital, physician visits and hospice case during the last six months of like among cohorts loyal to highly respected hospitals in the United States. BMJ 2004.)
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In 2004, such inappropriate or unnecessary care translated to an estimated $300 billion per year. (Source: Brailer D. The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care, Framework for Strategic Action. Washington, DC: Dept. of Health and Human Services, Office of the National Coordinator for Health Information Technology; 2004.
Fact: Most physicians still use paper records. The latest data from the National Ambulatory Medical Care Survey (NAMCS) indicate that one-quarter of office-based physicians reported using fully or partially electronic medical record systems in 2005, a 31 percent increase from the 18.2 percent reported in the 2001 survey.
Fact: The benefits of electronic medical records far outweigh the costs.
-> Estimates of the investment necessary to drive widespread adoption of electronic medical records vary. A 2004 study by the Markle Foundation under the Connecting for Health Initiative found that the ongoing costs to physicians implementing an EHR range on average between $12,000-$24,000 over three years, including such impacts as volume-based revenue loss and lost productivity.
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By eliminating unnecessary and duplicative procedures, improving quality by eliminating errors, and bringing less efficient hospitals and physicians up to the performance of the most efficient ones, some researchers have suggested that up to 30 percent of annual Medicare healthcare spending could be saved. (Source: Fisher E, Wennberg D, Stuckel T, Gottlieb D, Lucas F, Pinder E. The implications of regional variations in Medicare spending, Part 2: The Health Outcomes and Satisfaction with Care. 2003; 138:273-287.)
