The Implementation Special Interest List of AMIA has been recently discussing the issue of whether Health IT can reduce the costs of health care. Reference was made to this article: Doctors Say Health IT Will Result in Higher Costs, Report Finds, which prompted one contributor to ask if there was any evidence that HIT reduced costs. Our comments follow this request:
There is every reason to predict that BadHIT will increase costs for these reasons:
-
BHIT gives more attention to recording more detail about the clinical encounter with the objective of identifying more billable items — this puts up cost because staff spend more time recording information and so can see less patients, plus the charges for any given episode of care go up as more chargeable items are recorded.
-
There is no evidence that BHIT produces significant enough improved patient outcomes with fewer bad health episodes so that the patients’ decrease in attendance offsets the increase in costs for the earlier attendance — that is, there are no downstream advantages demonstrated.
-
GoodHIT also has a credibility gap on these two types of evidence but it has one saving grace — staff believe and in some cases can show that GHIT enhances their work activities — this leads to improved morale amongst staff, which is likely to lead to improved productivity or at least no loss of productivity — this in turn is likely you lead to more caring care if not improved outcomes so it should at least register in comparative patient satisfaction surveys, if nothing else.
-
The real gains in HIT will be found when the price of HIT drops by a factor of 10 and the clinical teams can design systems that match their workflows without the software engineers getting in their way.