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Health Information Technology (HIT)

2012-08-06


Through my past work at a pediatric primary care office and my internship at the Rhode Island Department of Health, I have developed a deep interest in and passion for health and medicine. So for me, the greatest advancement in the information and communications technology industry over the last 10 years has been Health Information Technology (HIT). This technology is not only pertinent for the maintenance of patient data through the use of electronic health records (EHRs), but it also allows for health information exchange (HIE). The U.S. Department of Health and Human Services argues that HIE builds ďcapacity for exchanging health information across the health care system both within and across states.Ē (ďState Health Information Exchange Cooperative Agreement Program,Ē healthit.hhs.gov). They also argue that it facilitates connectedness within the health care system and improves quality and efficiency, as information is consolidated better and travels faster. If a patient is on vacation and falls ill has to go into the ER, HIE exchange can make it possible for the ER doctor to access this out of state patientís records and see if they are allergic to any medications, for example, or if they have been on any medications recently, or any number of things. Health Information Exchange may also be beneficial down the road for exchange between nations as well. For my senior thesis I am writing about the importance of learning from other countries about how to build the best health care system. Exchange need not only be in terms of ideas. What is so wonderful about HIE is that health data is now computerized and may be stratified by certain demographics or health categories. That way we might one day consolidate data so that we might compare numbers with other countries, analyzing what produces positive health comes and what hinders good health.

In terms of HIT in general, the Department of Health and Human Services notes that this technology will not only improve patient care but our nationís health care system as a whole. It will improve patient care because patientsí medical records will be concisely organized in an EHR; that way a patientís past and present medical history will be easily accessible and the best possible care may be administered. If the patient has a chronic condition, care between doctors can be more easily coordinated because each physician they see has access to their full records and can see what others have advised and administered. A patient also has access to their information, enabling them to be actively involved in their care; they are informed and more self-empowered to make decisions than they might have been before. EHRs are also environmentally friendly, eliminating paper charts and files, and reduce the room for medical errors as they are not flipping back to chicken scratch notes from years ago; everything has become available to them on a computer screen.

What I think is most important, however, is HITís contribution to our nationís health care system as a whole. Though our country is debating many critical issues right now, I would argue that health reform might be the most important. Health is a human right, and it is shameful to admit but the truth is that our health care system is not built to ensure and protect this right. At my internship, one of the key tenants of U.S. Health Reform on which we have been focusing is the idea of the Patient-Centered Medical Home. This initiative aims to address may of the issues that make our system as unacceptable as it is. For example, each patient has an ongoing relationship with a personal physician who provides them with ongoing, comprehensive care. Quality and safety are assured and patient feedback and input is considered. And, access is enhanced through improved means of communication between the practice and its patients. An important step in creating a Patient Centered Medical Home is adopting HIT and EHRs. That way, these tenants regarding improving patient care coordination, enhancing communication channels, and reducing waste are ensured. HIT is an integral component of necessary health care reform in this country.

We should also be concerned with cutting costs in our health care system. According to the World Health Organization, the United Statesí total expenditure on health per capita was $6,714 in 2006, while the total expenditure on health as a percentage of GDP was 15.3%. According to the U.S. Department of the Treasury, Bureau of the Public Debt, as of April 18, 2011, the U.S. national debt was $14,309,159,097,877.65. We are in a financial crisis! Our country is looking to cut costs everywhere, including within the health care system. HIT can reduce costs. How? Physicians flipping through records might not see a test that was recently ordered and order that same test again. That is a waste of money. Unnecessary tests will not be ordered because an electronic health record will clearly indicate that that test has already been done. Another example of how HIT can cut costs is reducing time between ordering tests, issuing results, and administering care. With the speed of HIT, findings can be communicated with the patient and a care plan developed sooner so that conditions do not worsen. Worsened conditions may lead to more costly care needed down the road. Health care should be more about pay for performance rather than fee-for-service; in other words, it is not about the number of tests done but about the quality and efficiency of the care given.

I will be attending the University of Limerick in the Fall to pursue a Master of Arts in Development, in the hopes of next year applying for the Master of Science in Health Informatics program. The Health Informatics major directly embodies with the aforementioned importance of HIT:

[It] focuses on the creation, modeling, management and sharing of health data and knowledge to support data analysis and timely decision making in medicine and health care together with the information science and technology to support these tasks. It is not solely a technical discipline but focuses on the relationship between the technology and its use in real-world settings i.e. solutions are designed in context, taking into account the social, cultural and organizational settings in which computing and information technology will be used in health care sectors...Graduates are equipped with skills to... evaluate the opportunities and limitations of health care technology and of its impact in improving the efficiency, cost- effectiveness, safety and quality of health care delivery. (ul.ie)

Through my choice of this course of study, it is easy to see why I believe that HIT is the greatest advancement in the information and communications technology industry over the last 10 years. The need for health care reform in our country is pressing. What I hope to take away from both of my Masters programs at the University of Limerick is both the knowledge of how to develop new ideas and technologies to meet the needs of today, while furthering my understanding of the importance of HIT and how it might be argued as one of the most pivotal components of health care reform.