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5:19イ LTE くBack Research Paper Topic HT.docx h Research Paper: Healthcare Technology Topic: Healthcare Information Technology and Economics Abstract Key words: Electronic Health Records, Economics Health Reform, Benefit Analysis, Information Systems Introduction: The state of current healthcare costs and health IT plans The consequences of high healthcare costs The role of IT in reducing the costs and improving the quality of health Is there evidence health IT is worth our investment? Conclusion: 3 References: 4 to 5 pages of research-(not including the cover sheet abstract, and reference page). Dashboard Calendar To DoNotifications Inbox

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Healthcare information technology and economics

ABSTRACT

At the 2011 American College of Medical Informatics

(ACMI) Winter Symposium we studied the overlap

between health IT and economics and what leading

healthcare delivery organizations are achieving today

using IT that might offer paths for the nation to follow for

using health IT in healthcare reform. We recognized that

health IT by itself can improve health value, but its main

contribution to health value may be that it can make

possible new care delivery models to achieve much

larger value. Health IT is a critically important enabler to

fundamental healthcare system changes that may be

a way out of our current, severe problem of rising costs

and national deficit. We review the current state of

healthcare costs, federal health IT stimulus programs,

and experiences of several leading organizations, and

offer a model for how health IT fits into our health

economic future.

INTRODUCTION

US investment in health information technology

(IT) has risen substantially since 2008 while the

focus on the national deficit and rising healthcare

costs has sharpened. This convergence makes it

opportune to review how health IT can influence

healthcare spending and provide financial return on

the nation's investment in it. The overlap between

health ITand economics was the theme of the 2011

American College of Medical Informatics (ACMI)

Winter Symposium at which invited guests and

ACMI fellows presented perspectives on this issue,

and studied the current achievements of leading

healthcare delivery organizations for insights into

the paths the nation might follow in using health

IT in healthcare reform.

We recognized, in summary, that health IT by

itself can improve health value (defined as utility/

costs), but its main contribution to health value

may be that it can make possible new care delivery

models to achieve much greater value. Thus, health

IT is a critically important enabler of fundamental

healthcare system changes that may provide a

solution to our current, severe problem of rising

costs and national deficit. If true, national invest-

ment in health IT is extremely important now as we

struggle to decide among competing alternatives for

the future of the American healthcare system.

In this article, participants in the ACMI meeting

review the current state of healthcare costs, federal

programs to stimulate use of health IT, and the

experiences of several leading organizations, and

then offer a model for how health IT fits into the

economic future of our health. We concentrate on

topics discussed during this meeting, but do not

address many other topics important to analysis of

the relationship between health IT and economics,

including (but not limited to) current reliance on

billing data with less attention given to ontologies

and terminologies, patient safety and its enormous

economic implications, privacy, translational bioin-

formatics, population health, and healthcare equity.

THE STATE OF CURRENT HEALTHCARE COSTS AND

HEALTH IT PLANS

The USA likely spends too much money on

healthcare. In 2005, expenditure on healthcare was

$6041 per capita, more than double the median of

$2922 spent in the 30 industrialized countries of

the Organization for Economic Cooperation and

Development.

1

By 2008, annual per capita health-

care spending had risen to $7681, with a total for

the nation of over $2.3 trillion, three times the 1990

estimate.

2

Expenditure growth has exceeded overall

cost inflation and GDP growth every year for the

last 10 years and, without structural changes, this

trend is expected to continue. Roughly, 31% is

spent on hospital care, 21% on physician services,

10% on prescription drugs, and 8% on nursing

home care, with the remaining 30% spread over

capital investment, insurance profits, administra-

tive costs, home health, public health, and other

health-related items.

2

Meanwhile, the USA, as of

2006, ranked 39th for infant mortality, 43rd for

adult female mortality, 42nd for adult male

mortality, and 36th for life expectancy.

3

The high

spending level has numerous causes, including

the fee-for-service payment system, the lack of a

national single-payer system, the entrepreneurial

nature of the healthcare industry, the continued

embrace of high technology testing and treatment

modalities, and the well-documented geographic

disparities in age- and income-adjusted utilization

and expenditures, up to threefold, with minimal

health benefit resulting from higher expenditure.

4

The consequences of high healthcare costs

The US employer-based system for insuring the

healthcare costs of working Americans and their

families covers 160 million people. According to the

National Association of Manufacturers, 97% of its

members provide health insurance, with highly

variable and decreasing coverage and increasing co-

pay provisions. Many smaller employers do not

offer or do not subsidize insurance. The National

Association of Manufacturers reports that insurance