Health Information Technology: Federal Agencies' Experiences Demonstrate Challenges to Successful Implementation
The GAO has released Health Information Technology: Federal Agencies’ Experiences Demonstrate Challenges to Successful Implementation, GAO-09-312T, January 15, 2009.
Health IT has the potential to help improve the efficiency and quality of health care, but achieving the transition to a nationwide health IT capability is an inherently complex endeavor. A successful transition will require, among other things, addressing the following issues: (1) Establishing a foundation of clearly defined health IT standards that are agreed upon by all important stakeholders. Developing, coordinating, and agreeing on standards are crucial for allowing health IT systems to work together and to provide the right people access to the information they need: for example, technology standards must be agreed on (such as file types and interchange systems), and a host of content issues must also be addressed (one example is the need for consistent medical terminology). Although important steps have been taken, additional effort is needed to define, adopt, and implement such standards to promote data quality and consistency, system interoperability (that is, the ability of automated systems to share and use information), and information protection. (2) Defining comprehensive plans that are grounded in results-oriented milestones and measures. Using interoperable health IT to improve the quality and efficiency of health care is a complex goal that involves a range of stakeholders, various technologies, and numerous activities taking place over an expanse of time, and it is important that these activities be guided by comprehensive plans that include milestones and performance measures. Without such plans, it will be difficult to ensure that the many activities are coordinated, their results monitored, and their outcomes most effectively integrated. (3) Implementing an approach to protection of personal privacy that encourages public acceptance of health IT. A robust approach to privacy protection is essential to establish the high degree of public confidence and trust needed to encourage widespread adoption of health IT and particularly electronic medical records. Health IT programs and applications need to address key privacy principles (for example, the access principle, which establishes the right of individuals to review certain personal health information). At the same time, they need to overcome key challenges (for example, those related to variations in states’ privacy laws). Unless these principles and challenges are fully and adequately addressed, there is reduced assurance that privacy protection measures will be consistently built into health IT programs and applications, and public acceptance of health IT may be put at risk.