Report From Sen. Whitehouse Highlights Importance of HIT In Delivery System Reform

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Implementation and use of health information technology is a key factor in reforming health care delivery and will greatly reduce the cost of health care, according to a March 29 report from Sen. Sheldon Whitehouse (D-R.I.).

The report, Health Care Delivery System Reform and The Patient Protection & Affordable Care Act, identifies five priority areas for reform, and how they each could potentially reduce costs and improve care :

  •  payment reform;
  •  primary and preventive care;
  •  measuring and reporting quality;
  •  administrative simplification; and
  •  health information technology.

“These reform efforts are the best way to lower costs and improve quality in our health care system,” Whitehouse said in a statement. “Efforts such as encouraging people to receive preventive care and investing in health information technology can help reduce medical errors, save many billions of dollars, shore up programs like Medicare and Medicaid, and give American patients even better care than they have now.”

Whitehouse is a member of the Senate Health, Education, Labor, and Pensions Committee.

The report comes at a time during Republican efforts to repeal the Patient Protection and Affordable Care Act (PPACA) and the U.S. Supreme Court is poised to decide whether a key provision of the legislation--the insurance madate--is constitutional. A repeal of the law could affect the nation's progress toward widespread adoption of health IT, according to the report.

“[PPACA] creates the conditions that allow innovation to take place and has the mechanisms needed to propagate reforms as quickly as possible when they are proven effective,” the report said.

According to the report, health care delivery system reform could save between $700 billion and $1 trillion per year.

ACOs, Safety Improvement Via HIT.

PPACA's payment reforms, pilot projects, and other delivery system reforms are “built with the expectation of having IT-enabled providers,” the report said.

In particular, the shift to new models of care, like accountable care organizations, will rely on information exchange and reporting quality outcomes via electronic health records. The formation of ACOs is contingent on having providers “online” to transfer information and patient records and report quality measures, according to the report.

Specifically, PPACA incorporates more sophisticated uses of health IT as a central component or requirement of existing health care programs, such as the Hospital Value-Based Purchasing Program, the Medicare Shared Savings Program, the Medicaid Health Home Option, and the quality reporting provisions for long-term care facilities, cancer hospitals, and psychiatric hospitals.

Additionally, the adoption of health IT is associated with improvement in patient safety, according to the report.

Using different forms of health IT, such as computerized physician order entry, the most common causes of preventable injuries and deaths in hospitals--medication errors--can be reduced. According to the report, the implementation of CPOE systems is associated with a reduction in medication errors of 55 percent.

HIT Adoption Growing.

While health IT adoption has historically been slow, the report said, the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act (ARRA), changed the landscape by creating an incentive program for “meaningful use” of certified EHR technology.

Since January 2011, more than 211,600 providers and hospitals have registered for the Medicare and Medicaid EHR incentive programs. Furthermore, more than 62,000 providers and hospitals have received almost $3.8 billion in incentive payment for successful attestation to meaningful use of EHRs (see previous article).

“With an IT-enabled health system, data flow and analysis can occur in 'real time,' creating a rapid flow of new information on how to achieve what HHS calls the 'Triple Aim'--better health, better care, and lower costs,” the report said.

The report is available at