Connected Health in the United States

Initiating Change

A comprehensive Accenture study, Connected Health: The Drive to Integrated Healthcare Delivery, looks at how eight different health systems are progressing on the journey to better healthcare—one that uses the systematic application of healthcare information technology. The US has begun its journey with legislative activity, but it still faces a long road.

With a multi-billion dollar investment to further healthcare IT adoption and health information exchange usage, the US federal government is building momentum toward connected health. Recent government legislation―including the Affordable Care Act and the American Recovery and Reinvestment Act (ARRA)―is providing a strong impetus for change. The Health Information Technology for Economic and Clinical Health Act (HITECH) sets aside $27 billion to foster physicians’ and hospitals’ use of electronic health records (EHR), providing incentives for healthcare providers that set up and demonstrate “meaningful use” of such medical record systems.

Accenture’s research shows there are three distinct stages in the journey toward connected health: healthcare IT adoption, health information exchange (HIE) and insight driven healthcare. The US is making progress, but it has largely been patchy and fragmented.

• Healthcare IT adoption. While ARRA stimulus funds have increased progress toward healthcare IT over the past few years, there is still some way to go before adoption levels reach a point that enables comprehensive information sharing.

• Health information exchange. Despite recent government efforts to build momentum around health information exchange as a critical part of the Affordable Care Act, sharing health information widely across the system is still a distant goal.

• Insight-driven healthcare. Given the fragmented picture of healthcare IT adoption and information exchange across the US healthcare system, value optimization remains in the early stages. There is still optimism, however, over the potential value once the levels of meaningful use of healthcare IT matures.

Two main barriers hold back healthcare IT adoption in the US. One is the need to encourage behavioral change across the system, addressing physician skepticism (including cultural and workflow changes). The other is the need to provide incentives for sharing information across a largely competitive system. Other challenges include:

• Cost: One of the fundamental problems with connected health, experts point out, is that investment in healthcare IT does not pay immediate dividends making organizations reluctant to invest.
  
  
• Lack of interoperability standards: Electronic health system interoperability is critical to the success of connected health to avoid a situation one expert characterizes as “the Tower of Babel where each electronic medical record is speaking a different language.”
  
  
• Privacy and security concerns: While most experts agree that privacy and security issues pose challenges to the progress of connected health, some argue that the majority of patients are in fact willing to share their personal information, assuming their data is being kept secure, in return for improved service.

To attain its connected health goals over the next five years, experts say the US must develop an infrastructure that helps capture a core set of patient information. This information should be able to “follow the patient” through the healthcare system, enabling any authorized medical professional to access appropriate levels of data to improve individual, community and population health. It should also have appropriate privacy and access controls in place.

Most healthcare leaders agree that the government will continue to play a critical role in connected health development, specifically in setting the strategy, vision and direction, creating standards and providing incentives for adoption and usage. This is particularly important if the US’s proposed Nationwide Health Information Network is to come to fruition. However, most feel that an overly prescriptive federal government that micromanages the process could stifle progress and innovation at the local level.

To build and sustain momentum, the US will have to address and overcome key challenges, particularly those relating to sustainability of funding and payment models as well as physician resistance to change.