Health IT systems hinder care integration

Health IT is hindering, rather than enabling, integration of care across multiple settings and efforts to improve healthcare value, two healthcare specialists argue in a Harvard Business Review blog post.

"Most clinical information systems have been designed around specialties, procedures, or care sites, and focused on scheduling and fee-for-service billing," Harvard business professor Michael E. Porter and Thomas H. Lee, M.D., chief medical officer for healthcare management consultant Press Ganey, write in the commentary.

"Few systems were designed to keep track of individual patients over a full care cycle, and provide all the caregivers involved with comprehensive patient information."

Those limitations mean it's rare for providers to have complete information about their patients--a problem exacerbated by information systems that "also make it almost impossible to collect information on outcomes that matter," they say.

Payer IT systems may be even worse, they add, since they are designed to pay bills for individual services rather than measure "overall care and value for patients. Most insurers cannot even capture whether a patient is dead or alive."

To improve the value proposition, the healthcare system will need to build new kinds of IT platforms that support and integrated process of change, they say in the commentary, referring to a companion article in October's Harvard Business Review outlining their full proposal.

The author's contentions are in contrast to arguments that health IT "is a substantial enabler to care integration. … You almost cannot do complex medical care without that kind of connectivity," according to David M. Lawrence, M.D., retired chairman and CEO of Kaiser Foundation Health Plan and Kaiser Foundation Hospitals.

In a report, "Order From Chaos: Accelerating Care Integration," released by the Lucian Leape Institute at the National Patient Safety Foundation, Lawrence and his co-authors highlighted six areas they said must improve if care integration is going to improve.

For more information:
- read the commentary
- read the article
- read Leape report

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