Technology for Patient Care in Physician Offices

Providing Insights that Contribute to Better Health Policy W the Institute of Medicine (IOM) has identified information technology as playing a pivotal role in systematically improving the quality of clinical care and reducing health care costs, the health care industry adopts IT at a relatively slow pace compared with other industries. Recently, momentum for both public and private initiatives to promote IT adoption in hospitals and physicians’ offices has been building, and the federal government, in particular, has stepped up efforts to foster IT adoption. While the use of IT in physicians’ offices potentially can improve quality and reduce costs, implementation is costly because of up-front investments in capital, training and integrating IT systems with existing administrative and clinical processes. The business case for physician implementation of IT to improve health care quality is still being made, since the benefits of lower costs and improved health are uncertain and generally accrue more directly to health plans, employers and patients than to physicians. As a result, many physician practices may be reluctant to introduce IT beyond administrative and management systems that directly affect revenues. If policy makers want to encourage IT Evidence of physicians’ use of information technology (IT) to support patient care has been sketchy and anecdotal to date. However, new findings from the Center for Studying Health System Change (HSC) show wide variation in information technology adoption across physician practices, particularly by physician practice size. In 2001, nearly 60 percent of physicians in traditional practice settings—primarily solo or relatively small group practices where the vast majority of Americans receive care—reported that their practice used information technology in no more than one of the five following clinical functions: obtaining treatment guidelines, exchanging clinical data with other physicians, accessing patient notes, generating treatment reminders for the physician’s use and writing prescriptions. Highest levels of IT support for patient care were found in staffand group-model health maintenance organization (HMO) practices, followed by medical school faculty practices and large group practices. Overall rates of information technology adoption may have increased since 2001, but the variation in IT adoption by practice setting is unlikely to have changed. LIMITED INFORMATION TECHNOLOGY FOR PATIENT CARE IN PHYSICIAN OFFICES