Moving health care into the information age

Technology has already transformed the way you do business. Now it may change the way you manage your health. Imagine a day when all of your medical history is digitized, available to you at a moment’s notice from your laptop or cell phone. You could track your own blood pressure, blood sugar and cholesterol—a great motivator to stick to your diet and exercise plan. You could set up e-mail reminders that would prompt you to get your annual check-up and refill your prescriptions.

Imagine that you receive a phone call from your elderly mother, who has a question about one of her medications. Because you have been given authorization by your mother to view her health records, you are able to check on the prescription in question. You also see that it is time she visited her cardiologist. You go online to schedule an appointment with your mother’s doctor, and at the moment you set up the appointment, your mother’s insurance company automatically receives a notice to start the referral paperwork.

Digitizing personal health records, and making all of that information available to everyone authorized by the patient to see it, has the potential to reduce health care costs, improve patient outcomes and give ordinary people more control over their own personal health management. Digital records could link everything in the world of personal health care, from the medical to the financial.

The federal government agrees. In 2004, the federal government mandated that by 2014, most Americans must have an electronic health record. What kind of technologies will make digital health records not just possible, but readily accepted and easy-to-use? What are the other opportunities that information technology offers for improving patient safety and quality of health care, while at the same time reducing costs?

The Smith School’s Center for Health Information and Decision Systems (CHIDS) is at the very forefront of exploring the business phenomena and structural barriers associated with health IT. CHIDS is the first research center to address health informatics issues from a broad business perspective, rather than just a policy or patient care perspective.

“There are a whole range of technological issues that have to do with interoperability, sharing information across organizational boundaries, creating databases and data structures to store the information, and information security. But there are also organizational and behavioral issues surrounding the adoption of this technology and incorporating it into an existing workflow. There are economic issues to consider as well: how much to invest in this, and what is the return on the investment,” says Ritu Agarwal, Robert H. Smith Dean’s Chair of Information Systems, and director of the center.

“The barriers to technology adoption that exist in every other industry also exist in health care, but with another layer of complexity, especially as it concerns patient privacy and the lack of a single standard that could make this interchange happen,” adds Corey Angst, PhD ’07, the center’s associate director.

A team of graduate and undergraduate students works with Agarwal, Angst and other Smith School faculty on research projects ranging from the investigation of mobile computing in hospitals to legislation related to health IT and its impact on the health care industry. CHIDS has researched the adoption and diffusion of digital medical records, the business value of health IT, the effect of technology on workflows in hospitals, optimizing various operations in health facilities such as the allocation of beds, and the readiness of physician’s practices to adopt electronic medical records. The center circulates quarterly briefs describing their research results, which can be viewed online.

As well as producing cutting-edge research, CHIDS is also actively working with federal and regional health agencies to drive policy decisions about health care technologies. Agarwal and Angst have given expert testimony to the Department of Health and Human Services’ National Committee on Vital and Health Statistics (NCVHS), the American Health Information Community (AHIC) Consumer Empowerment Workgroup, the Office of the National Coordinator for Health IT, the Markle Foundation’s Connecting Americans initiative, and many others.

Incorporating information technology into the delivery and management of health is more than an academic issue: it has life and death implications. This technology has the potential to reduce, if not entirely eliminate, many unnecessary deaths each year. “According to an Institute of Medicine report in 1999, almost 100,000 people die every year as a result of medical errors that could have been prevented. If we have a complete medical record that goes with us, anyone who treats us will know all of our information, which could cut down many of those medical errors,” says Angst. He also points to the cost benefits that digitized records will make possible. “If we could just reduce duplicate tests by making information available to multiple entities involved in treating a patient, we could significantly improve efficiencies within the system.”

Support for CHIDS comes from a wide range of industry stakeholders, from pharmaceutical companies such as Johnson&Johnson and Pfizer, to insurance providers, to IT vendors and others. The center recently received a planning grant from the National Science Foundation (NSF) and a subcontract from the Department of Health and Human Services’ Assistant Secretary for Planning and Evaluation (ASPE).

Learn more about CHIDS