Gains from health IT won't show without more reform, researchers say

ARLINGTON, VA – It's going to take more healthcare reform for productivity gains to show up from HIT adoption, according to a new report.

A RAND Corporation report published Thursday in the New England Journal of Medicine finds that existing administrative data used to measure productivity gains may be unable to detect the progress.

 [See also: Mostashari rankled over HIT survey conclusions.]

“As seen previously in manufacturing and other industries, the benefits of computerization in healthcare may only become evident over time as the delivery of healthcare is reengineered,” said Spencer Jones, the paper’s lead author and an information scientist at RAND, a nonprofit research organization.

“Health IT has the power to change the way healthcare is delivered and we need to develop tools that can accurately measure the impact of those changes,” Jones said.

One recent RAND study found that less than 2 percent of ambulatory performance metrics were suitable for measuring the effects of computerization, with other performance measures unable to capture improvements that can be made through health IT, according to researchers.

For example, health providers who use telephone calls or email in lieu of some office visits will appear to be less productive based on existing healthcare productivity measures, even if they deliver care in a more-convenient and effective fashion than other providers, according to the RAND health analysis.

In the analysis, RAND researchers discuss a productivity paradox that became apparent during the computerization of many other U.S. industries during the 1970s and 1980s. Despite a vast increase in computing capacity, the growth of productivity fell dramatically during the period. The relationship became known as the “IT productivity paradox” and economists debated whether the investments in it were worthwhile.

Further study showed that once these industries reengineered their processes to fully harness the benefits of IT, the anticipated productivity gains were realized.  But it took time for this to happen.

For health IT to produce similar gains, the healthcare professions need to do more than just digitize paper-based workflows, according to the RAND analysis. Health IT should lead to new processes that support teamwork, care coordination and innovative approaches such as interactive patient portals.