TIME TO DO SOMETHING ABOUT HIT by David Torchiana, MD

We all know that cost management is important to the success of Massachusetts health reform and that there are a lot of ideas out there. One that nearly everyone agrees on is the need for greater health information technology (HIT) adoption, particularly electronic medical records (EMR) and computerized provider order entry (CPOE).

The New England Healthcare Institute released a report last week that showed that universal adoption of CPOE across Massachusetts would save $170 million a year and avoid 55,000 potentially serious adverse drug events. That means each physician could expect to avoid 9 adverse drug events a year and could prevent three life-threatening ones every five years. Only 10 of 73 Massachusetts hospitals have adopted CPOE at present. The promise is just as great with EMR and the adoption rate just about as grim.

Unfortunately, hospitals with tight budgets and physician practices with limited resources feel that they cannot afford the needed step of HIT adoption. Aggravating the problem is the fact that most of the costs of adoption accrue to these same doctors and hospitals while the savings accrue upstream to the insurers and employers – a classic case of non-aligned incentives.

A simple set of policies could fix this, including mixing incentives and requirements to push providers ahead, with some financial help from other sectors of the healthcare economy. HIT is not a panacea but it clearly will be the foundation of a more rational, less fragmented system that costs less and delivers improved quality. We can’t afford to simply watch and wait.

David Torchiana, MD
Massachusetts General Physicians Organization

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