Defining metrics and guidelines for valuing Health IT

Realizing the Value of Health IT | New Visions Healthcare Blog

Health Information Technology: Beyond the Money -
Why HIT Makes Sense from a Business Process and
IT Perspective - Highlight

The Value of Health Information Technology: Filling the Knowledge Gap | RAND

Published in: The American Journal of Managed Care, v. 20, Special Issue No. 17, 2014, p. eSP1-eSP8

by Robert S. Rudin, Spencer S. Jones, Paul G. Shekelle, Richard Hillestad, Emmett B. Keeler

• Related Topics:
• Health Care Organization and Administration,
• Health Information Technology,
• Program Evaluation

Despite rapid growth in the rate of adoption of health information technology (IT), and in the volume of evaluation studies, the existing knowledge base for the value of health IT is not advancing at a similar rate. Most evaluation articles are limited in that they use incomplete measures of value and fail to report the important contextual and implementation characteristics that would allow for an adequate understanding of how the study results were achieved. To address these deficiencies, we present a conceptual framework for measuring health IT value and we propose a checklist of characteristics that should be considered in health IT evaluation studies. The framework consists of 3
key principles:

1. value includes both costs and benefits; 
2. value accrues over time; and 
3. value depends on which stakeholder's perspective is used. 

Through examples, we show how these principles can be used to guide and improve health IT evaluation studies. The checklist includes a list of contextual and implementation characteristics that
are important for interpretation of results. These improvements will make future studies more useful for policy makers and more relevant to the current needs of the healthcare system.


Even when information on costs, benefits, and perspective are presented, studies of HIT must then present sufficient information for readers to know what the intervention is, if readers are to be able to reach conclusions about whether the HIT system is something that could be implemented in another context. However, most evaluations of HIT do not adequately report such information. Few studies explain how the technology works, let alone how it was implemented. Furthermore, most studies don’t even report basic contextual information such as under what payment system the users were paid.

Studies need to open up the “black box” of HIT and do a better job explaining how HIT contributed to the results, including the role of key contextual factors. The need for particulars about the intervention details and implementation details has been noted by others for several years.4,34,35 All of these authorities recommend including at least 3 descriptors of the intervention: what the functionality does, contextual information, and implementation information. HIT evaluation studies need to describe this information so that a reader can understand what was being evaluated and assess whether or not they might be able to realize that value if they were to try to implement the same intervention in a different context.

- See more at: http://www.ajmc.com/publications/issue/2014/2014-11-vol20-sp/the-value-of-health-information-technology-filling-the-knowledge-gap/2#sthash.eZ66tKr1.dpuf

Related Posts and Background Links

MHA e-Briefing: Understanding the Value of Health Information Technology - School of Public Health

Clinical errors cause at least 44,000 deaths annually. With direct medical costs of $17 billion annually, these errors impose a substantial burden on both the health care system and society as a whole (Institute of medicine, 1999). Public and private sector leaders have responded with calls for technological solutions to the medical errors problem. The Institute of Medicine has argued that computerized physician order entry (CPOE) could address many underlying causes of inpatient errors. Similarly, Hillestad and colleagues (2005) estimate that health information technology (IT) may yield savings in excess of $100 billion per year. Consequently, subsidized adoption and implementation of health IT became US policy with the passage of the HITECH Act in 2009. 

Evaluating the Value of Healthcare Information Technology: Finding the Diamond in the Rough, and Tumble

The value of healthcare information technology has never been more important. Identified as a key component of healthcare transformation to reduce costs and improve quality, deriving maximal value from considerable healthcare information technology investment in both the local office or hospital setting, as well as the national or societal context, remains difficult(1;2).

Despite continued pressure from both the public and private payer community, and increasing evidence on the value of information technology albeit from isolated settings, adoption of healthcare information technology proceeds at a snail’s pace. Studies performed at the Center for Information Technology Leadership suggest that significant potential exists for healthcare savings exists at the national and local level with adoption of several forms of healthcare information technology. These studies, however, examined information technology from particular technology vantage points, for example, ambulatory CPOE, or information exchange and interoperability.

Even
when information on costs, benefits, and perspective are presented,
studies of HIT must then present sufficient information for readers to
know what the intervention is, if readers are to be able to reach
conclusions about whether the HIT system is something that could be
implemented in another context. However, most evaluations of HIT do not
adequately report such information. Few studies explain how the
technology works, let alone how it was implemented. Furthermore, most
studies don’t even report basic contextual information such as under
what payment system the users were paid.

Studies need to open up
the “black box” of HIT and do a better job explaining how HIT
contributed to the results, including the role of key contextual
factors. The need for particulars about the intervention details and
implementation details has been noted by others for several years.^4,34,35
All of these authorities recommend including at least 3 descriptors of
the intervention: what the functionality does, contextual information,
and implementation information. HIT evaluation studies need to describe
this information so that a reader can understand what was being
evaluated and assess whether or not they might be able to realize that
value if they were to try to implement the same intervention in a
different context.
- See more at:
http://www.ajmc.com/publications/issue/2014/2014-11-vol20-sp/the-value-of-health-information-technology-filling-the-knowledge-gap/2#sthash.eZ66tKr1.dpuf