Filling the HIT Gaps

You have seen much talk here and elsewhere about the low pentration of EHRs and the importance of broader HIT adoption within the hospital and physician communities.Certainly, the findings from a Health Affairs 2005 study did not come as a big surprise to anyone. In "Functional Gaps In Attaining A National Health Information Network," the authors identified skilled nursing facilities and home health as having the largest functional gaps across the healthcare spectrum, significantly lagging behind hospitals and physicians, and a critical missing link to enabling a national health information network.

"Widespread adoption of HIT is an initial step in developing an NHIN. If large stakeholders such as hospitals continue to rapidly advance in HIT adoption and smaller stakeholders such as office practices and home health care agencies lag behind, large inequities will result."

There are many reason why this is true, and in "Nursing Homes Receive Tech Cures" in today's Wall Street Journal, the author highlights many of the technological challenges within the nursing home industry as well as some of the efforts being made.

"With about 1.5 million residents spread among the nation's 16,000 facilities, they are traditionally small and locally run, lacking the resources for technology overhauls. Many residents stay for years and require treatment for multiple chronic conditions, making medical record-keeping complex."

In May 2006, New York State announced one of the largest matching-fund HIT grant programs called the Health Care Efficiency and Affordability Law for New Yorkers HEAL-NY. The state has dedicated $1B over a four-year period to cover relevant HIT projects across a broad range of eligible entities including hospitals, nursing homes, physicians, assisted living, home health, hospice, payers, and pharmacies. This use of state funds is intended to promote HIT as a means to improve quality and efficiency for all in the state.

And clearly many other states including Massachusetts and California are embarking on other similar endeavors.

We see several bills in Congress that would help bridge the HIT gaps on a broader national scale, rather than leaving these efforts to each individual state. I suspect that we will hear much hype - but less action - prior to the next election cycle. This is one area where I'd like to be proven wrong.