Health Information Technology and the Electronic Health Record: Implications for Achieving High Performance in US Health Care

In 2004, US President George W. Bush articulated a vision of interoperable electronic health records within 10 years. Accenture has identified a number of steps that hospitals and health plans should put in place to play a significant role in implementing this vision—and progress toward high performance.

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In 2004, United States President George W. Bush set out a vision of interoperable electronic health records within 10 years.

A recent publication by Health and Human Services Secretary Tommy Thompson and Dr. David Brailer, national coordinator for health information technology, established four overarching goals:

• Informing clinical practice
• Interconnecting clinicians
• Personalizing patient care
• Improving population health

Health industry executives have long acknowledged the societal "good" of fostering technology adoption and applying health information technology to the clinical environment through electronic health records. This has the potential for improved patient safety and reduced medical errors as well as lower administrative and medical costs.

The barriers to implementing these technologies are high and the immediate tangible benefits to health organizations remain elusive.

As a result, the development of electronic health records in the United States has been extremely slow and lags behind many other countries. To remedy this, the following issues, which are challenging but not insurmountable, need to be addressed:

• Structural challenges
• Technical challenges
• Financial challenges
• Social and cultural challenges

The private sector realizes the value that electronic health records can bring. Respondents in the Fifth Annual Survey EHR Trends Usage, conducted in 2003 by the Medical Records Institute, cite the following reasons for the adoption of these records 50 percent of the time:

• Facilitate workflow improvement.
• Improve clinical documentation.
• Improve patient safety.
• Share comparable patient data.
• Meet the requirements of legal, regulatory or accreditation standards.
• Contain or reduce health care delivery costs.
• Establish a more efficient and effective information infrastructure.

Accenture has identified a number of steps that hospitals and health plans should begin to put in place to secure their leadership positions in local market-driven health information networks.

These steps can help lead hospitals further on their journey toward high performance:

• Begin a community dialogue on electronic health records.
• Start developing an IT infrastructure to support the processes of the advanced clinical information system.
• Engage physicians in the process of preparing for electronic health records.
• Start to engage local governments to help with local infrastructure creation.
• Redesign clinical documentation workflows by working with physicians and staff.
• Define and establish the service levels.
• Conduct a thorough assessment of patient safety.
• Conduct a thorough assessment of patient access.
• Establish a delivery and support model.
• Ensure compliance with privacy and security regulations.
• Develop a business case to guide the electronic health record development process.

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