Health IT (health information technology)

Contributor(s): Alex DelVecchio

Health IT (health information technology) is the area of IT involving the design, development, creation, use and maintenance of information systems for the healthcare industry. Automated and interoperable healthcare information systems are expected to improve medical care, lower costs, increase efficiency, reduce error and improve patient satisfaction, while also optimizing reimbursement for ambulatory and inpatient healthcare providers.

Types of health information technology

The electronic health record (EHR) is the central component of the health IT infrastructure. An EHR or electronic medical record is a person's official, digital health record and is shared among multiple healthcare providers and agencies. Other key elements of the health IT infrastructure are the personal health record (PHR), which is a person's self-maintained health record, and the health information exchange (HIE), a health data clearinghouse or a group of healthcare organizations that enter into an interoperability pact and agree to share data between their various health IT systems.

Implementations of EHR systems have increased dramatically in the past few years since the inception of the HITECH Act in 2009, which introduced the EHR meaningful use program. Physicians and hospitals that prove their use of government-certified EHR systems meets meaningful use criteria -- created and overseen by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT (ONC) -- are eligible to receive incentive payments. Meaningful use is changing to a new value-based reimbursement system under a law passed by Congress in 2015 called MACRA, the Medicare Access and CHIP (Children's Health Insurance Plan) Reauthorization Act. However, ONC continues to certify approved health IT technology used under federal reimbursement programs.

Picture archiving and communication systems (PACS) and vendor neutral archives (VNAs) are two widely used types of health IT that help healthcare professionals store and manage patients' medical images. In the past, radiology departments have been the primary repositories of medical images, but PACS and VNAs are integrating radiology into the main hospital workflow, and other specialties such as cardiology and neurology have also become large-scale producers of clinical images. In some instances, VNAs have been installed as a way to merge imaging data stored in separate departments' image banks in a multi-facility healthcare system.

Management of health IT systems

Due to the threat of patient data breaches, widespread use of mobile health devices and telemedicine technologies, and updates to health IT-related incentive programs and regulations, providers that adopt health IT systems sometimes replace or upgrade their systems.

Healthcare organizations and their business associates, such as third-party billing companies, that handle protected health information (PHI) are subject to the Health Insurance Portability and Accountability Act (HIPAAPrivacy Rule, created and enforced by the U.S. Department of Health and Human Services. The rule mandates that patients have full access to their PHI and protects the privacy of their information by limiting access to it by other parties. A healthcare provider that experiences a breach of PHI can be fined by the HHS Office for Civil Rights.

Benefits of health information technology

While some critics say EHRs have led to reduced physician productivity and produced cumbersome federal regulations, there is broad consensus on the benefits of health IT. These benefits include the ability to use data analytics and big data to effectively manage population health programs and reduce the incidence of expensive chronic health conditions, the use of cognitive computing and analytics to perform precision medicine tailored to individual patients, the ability to share health data among academic researchers to develop new medical therapies and drugs, and the rights of patients to obtain and use their own health data and collaborate in their own care with clinicians.

Health IT challenges

Some major challenges persist in health IT. Chief among them are obstacles to interoperability, including a lack of commonly agreed on health data interchange standards, although the health IT standard-developing organization HL7 International (Health Level Seven) has developed and promulgated several popular standards, most recently FHIR (Fast Health Interoperability Resources). Also, federal officials and patient advocates have identified as a pervasive problem the alleged practice of information blocking by some vendors and providers in an attempt to stymie the ability to share health data in their systems. Other ongoing concerns in health IT are the usability of EHR systems, with some physicians and other clinicians complaining about poorly designed user interfaces, and cybersecurity vulnerabilities that have made health systems susceptible to frequent cyberattacks on health data networks by criminals, foreign state actors and insiders.

This was last updated in June 2016

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What do you think the future of health IT holds?
The global healthcare IT market is expected to witness a strong growth, expanding at a CAGR of 13.1% from 2016 to 2023.
The move to digital based platform to help decrease a practice's overhead while managing things as simple as patient scheduling is part of the future. The availability of patient portals for accessing personal medical records is already improving the patient-doctor relationship and promoting engagement. It is quite exciting to see how the future is shaping up in such an important industry.
Something I find very frustrating in the health system is a lack of workflowed systems for office procedure.  There are no internal tracking systems and we have been told not to use databases to track to avoid duplication of work.  One person in an office has no clue what another person is doing, never mind what they are doing themselves.  Everyone has their own little systems and if there is a lack of continuity in service, no-one knows what exactly they have done or havn't done.  There is no use of generic email addresses in some systems so staff are being allocated the same tasks by the use of email and as departments are fragmented and staff are located in different buildings and offices, there is sometimes no communication or use of task allocation even in Outlook.

The IT systems are maintained by people who have never worked in the departments.  The system is managed by people who have absolutely no management, admin or IT skills ie nurses etc who have worked their way up into management posts.  Jobs are half done and admin is approached in a scatty and fragmented manner.  Some can't send emails, draw up a letter, build a database or create a spreadsheet, never mind amend them and constantly ask admin staff for training which never seems to sink in.

Every admin system in the NHS is laboured by paperwork, client files and disorganised methods.  Without proper workflow systems, administrators and managers are overworked leading to the need for micro management because staff are unable to cope.

This sounds like a rant which it probably is but it is drawn from frustration and extensive experience of workflow being used effectively in other environments.  Trying to get the value of it across to management is like dipping your toe in a pool knowing that you will never be able to swim.  So the future from an admin perspective is a carefully managed, workflowed organisation, with accountability for each unit.  Whether or not this will ever be an actuality is another matter unless we are taken over by the private sector.
Great article!
Information Technology security is vital for any organization that collects an individuals vital information. People are having a hard time trusting these systems when things like the Facebook and Cambridge incident happens. We must find a way to further educate people on these systems so they are more likely to trust and use these systems.


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