In 2009, in connection with the Health Information Technology for Economic and Clinical Health (HITECH) Act, the government set aside over $30 billion to promote the implementation and use of electronic health records (EHR). The policy objectives at the time encompassed a number of goals including: (1) improving the quality, safety and efficiency of care delivery; (2) engaging patients more fully in their care; (3) improving care coordination; (4) establishing an improved foundation for population health management; and (5) ensuring appropriate security protection for personal health information. Notwithstanding the good intent, significant dollar investment and focused encouragement associated with this initiative, EHR adoption, and its presumed benefits, have been slower than expected to emerge. Seven years and multi billions of dollars later the jury remains out.
On the one hand, great strides have been made in the number of physicians using an EHR. The percentage of
providers reporting implementation of at least a basic system has doubled since HITECH was passed, and now stands at just over 80%. On the other hand, it remains highly equivocal as to whether this expanded adoption has improved patient care, enhanced patient and physician satisfaction, or generated promised cost savings. For each of these questions, a quick Google search finds a myriad of conflicting statistics, opinions, and anecdotes, providing ample “evidence” to pronounce HITECH either a resounding failure or an undeniable success.
Rather than weigh in on either side of this debate, or offer what is likely a premature assessment of ultimate potential, I would instead like to flag several areas of both early success as well as concern, and to highlight several future areas of currently unlocked promise. In the area of clear wins, the percentage of physicians e-prescribing via an EHR grew from 7% pre-HITECH to over 70% by the end of 2014. This is important bec