How can health IT improve efficiency of care delivery?
Health care that is efficient allots the optimal level of care, while minimizing expenditures. Expenditures in the case of health care efficiency are not limited to monetary costs, however. While monetary cost can be considered as an input, research from both the Agency for Healthcare Research and Quality (AHRQ) and the American Medical Association (AMA) caution against considering a cost-effectiveness analysis or ratio to be analogous to efficiency of care delivery. Efficiency is also one of the domains of quality developed by the Institute of Medicine. Another way to conceptualize efficiency, however, is to understand it as the reduction of waste, such as reducing prescriptions of antibiotics for children in cases where they are not necessary.
According to findings from the RAND corporation in 2005, the adoption of electronic health records can generate billions in cost savings while improving quality and can reduce inputs by enabling, "shorter hospital stays prompted by better-coordinated care; less nursing time spent on administrative tasks; better use of medications in hospitals; and better utilization of drugs, labs and radiology services in outpatient settings." A winner of the HIMSS Davies award in 2003, Cincinnati Children's Hospital saves labor hours by charting electronically and providing physicians with immediate access to patient data. The hospital also developed an online portal for families of patients with chronic conditions, so that they can manage the childâ€™s care and communicate with providers long-distance. Another efficient user of health IT is Denver Health (PDF - 3.9MB), a network of 25 health care delivery sites that provide care to the medically underserved, many of whom are children. A study featured by AHRQ highlights the use of computerized physician order entry (CPOE) (PDF - 76KB) at Denver Health Medical Center concludes that the use of this health IT tool has produced statistically significant decreases in turnaround times and enhanced efficiency.
A January 2009 article published in Pediatrics notes that one of the functionalities of a pediatric EHR, laboratory tracking, has provided practices with increases in efficiency. However, the article also notes that partial EHR adoption, the lack of interoperability, and the slow pace of system-wide adoption have posed serious challenges to the potential for efficiency gains. Research from the AMA's Physician Consortium for Performance Improvement® (PCPI) emphasizes the relationship between technology and efficiency. Their research looks for ways to use technology to enable a process of production that optimizes across inputs (clinician labor, medication, health instruments, money) and outputs (health outcomes and health services) for all stakeholders, or technical efficiency and allocative efficiency respectively. Health IT can help improve efficiency of care delivery for children in numerous ways by enabling the most advantageous use of technology while better addressing the needs of patients, families, providers, payers, and other stakeholders. There are various instances documented in which health IT has already been utilized to achieve these goals through enhanced efficiency.
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