Key Players In Health Information Technology

Organizations Involved With HIT

Barriers to HIT Adoption

 3. Key Players In Health Information Technology

Patients, Physicians and Nurses, Support Staff, Public Health, Federal and State Governments,
Medical Educators, Insurance Companies (Payers), Hospitals, Medical Researchers and
Technology Vendors

Patients
• Online searches for health information and research choice of physician, hospital or insurance plan
• Smartphone technology for test message reminders, health and fitness apps, internet access, etc.
• Web portals for storing personal medical information, making appointments, checking lab results, e-
visits, drug refills, etc.
• Online patient surveys
• Online chat, blogs, podcasts, vodcasts and support groups and Web 2.0 social networking
• Personal health records
• Limited access to electronic health records and health information exchanges (HIEs)
• Telemedicine and home telemonitoring.
Physicians and Nurses

• Online searches with PubMed, Google and other search engines

• Online resources and digital libraries
• Patient web portals, secure e-mail and evisits, telehomecare
• Physician web portals
• Clinical decision support, e.g. reminders and alerts
• Electronic medication administration record (eMAR) and bar coding medications
• Electronic health records (EHRs)
• Smartphones loaded with medical software and remote access to EHRs
• Telemedicine and telehomecare
• Voice recognition software
• Online continuing medical education (CME)
• Electronic prescribing
• Disease registries
• Picture archiving and communication systems (PACS)
• Pay-for-performance (P4P)
• Health information organizations (HIOs)
• E-research
• Electronic billing and coding
Support Staff Public Health

• Patient enrollment • Incident reports

• Electronic appointments • Syndromic surveillance as part of bioterrorism program and Meaningful Use
• Electronic coding and billing program criteria
• EHRs • Establish link to all public health departments
• Web-based credentialing • Geographic information systems to link disease outbreaks with geography
• Web-based claims clearinghouses • Telemedicine
• Telehomecare monitoring • Disease registries as part of EHRs or health information exchanges
• Practice management software • Remote reporting using mobile technology
• Secure patient-office e-mail communication
• Online educational resources and CME
• Disease registries
Federal and State Governments

• Nationwide Health Information Network (HealtheWay)

• Financial support for EHR adoption and health information exchange
• Development of standards, services and policies for HIT
• Information technology pilot projects and grants
• Disease management
• Pay-for-performance
• Electronic health records and personal health records
• Electronic prescribing
• Telemedicine Medical Educators

• Broadband adoption • Online medical resources for clinicians, patients and staff
• Health information organizations (HIOs) • Online CME
• Regional extension centers • PubMed searches
• Health IT workforce development • Telehealth via video teleconferencing, podcasts, etc.
Insurance Companies (Payers)

• Electronic claims transmission

• Trend analysis through data analytics
• Physician profiling
• Information systems for quality improvement initiatives
• Monitor adherence to clinical guidelines
• Monitor adherence to preferred formularies
• Promote claims-based personal health records and information exchanges
• Reduce litigation by improved patient safety through fewer medication errors
• Alerts to reduce test duplication
• Member of HIOs
Hospitals

• Electronic health records

• Electronic coding and billing
• Information systems to monitor outcomes, length of stay, disease management, etc.
• eMARs
• Bar coding and radio frequency identification (RFID) to track patients, medications, assets, etc.
• Wireless technology
• E-intensive care units (eICUs)
• Patient and physician portals
• E-prescribing
• Member of health information organizations (HIOs)
• Telemedicine
• Picture archiving and communication systems (PACS)
Medical Researchers

• Database creation to study populations, genetics and disease states

• Online collaborative research web sites
• Electronic case report forms (eCRFs)
• Software for statistical analysis of data e.g. SPSS
• Literature searches with multiple search engines
• Randomization using software programs
• Improved subject recruitment using EHRsand e-mail
• Smartphones to monitor research
• Online submission of grants
Technology Vendors

• Applying new technology innovations in the field of medicine: hardware, software, genomics, etc.
• Data mining
• Interoperability
• Certification
 4. Organizations Involved With HIT
Academic Organizations, Public-Private Organizations and US Federal Government,

Academic Organizations
• Institute of Medicine (IOM) - leading organizations in the United States to promote health information technology is the
Institute of Medicine.
• The Association of American Medical Colleges (AAMC) - advocate of incorporating informatics into medical school curricula
and promoting health informatics in general.

Public-Private Organizations
• Bridges to Excellence - rewards practitioners who provide superior patient care, with special emphasis on caring for patients
with chronic conditions.
• eHealth Initiative- non-profit organization promoting the use of information technology to improve quality and patient safety.
• Leapfrog - Leapfrog is a consortium of over one hundred and seventy major employers seeking to purchase the highest quality
and safest healthcare.
• Markle Connecting For Health - over 100 stakeholders, its primary mission is to promote interoperable HIT.
• National eHealth Collaborative (NeHC) - This government-civilian-consumer collaborative took over in early 2009 when the
American Health Information Community (AHIC) was dissolved.
• Healthcare Information Technology Standards Panel (HITSP) - This panel was a public-private partnership established in
2005 by the Department of Health and Human Services (DHHS).
• The Certification Commission for Healthcare Information Technology (CCHIT) - reduce the risk of health information
technology (HIT) investment by physicians; ensure interoperability of HIT; enhance the availability of HIT incentives and
accelerate the adoption of interoperable HIT.
• National Committee on Vital and Health Statistics (NCVHS) - public advisory body to the Secretary of Health and Human
Services.

US Federal Government
• American Recovery and Reinvestment Act (ARRA) - the most significant recent governmental initiative.
• The Patient Protection and Affordable Care Act (PPACA) - increase insurance coverage and improve patient outcomes.
• US Department of Health & Human Services (HHS) - the department that serves as an umbrella for most of the important
government agencies that impact HIT.
• Office of the National Coordinator for Health Information Technology (ONC) - The most significant goal of (ONC) is the
creation of a universal interoperable electronic health record by the year 2014.
• Health IT Policy Committee (HITPC) – Information Exchange.
• Health IT Standards Committee (HITSC) - 26 multi-disciplinary members, 1 chair and 1 vice-chair that are tasked to look at
standards, implementation specifications and certification criteria for the exchange of health information.
• Agency for Healthcare Research and Quality (AHRQ) - The AHRQ is “the lead Federal agency charged with improving the
quality, safety, efficiency, and effectiveness of health care for all Americans.
• Centers for Medicare and Medicaid Services (CMS) - CMS is responsible for providing care to 47.5 million Medicare (2010
data) and 61.8 million Medicaid patients (2009 data).
• Centers for Disease Control and Prevention (CDC) - the CDC has used HIT to promote population health-related issues.
 5. Barriers to HIT Adoption
HIT adoption has the potential to transform healthcare and improve patient outcomes, but several barriers can
impede its widespread implementation.

Cost:
• One of the primary barriers to HIT adoption is the high initial cost of implementing electronic health records (EHRs) and
other HIT systems.
• The expenses include purchasing the software, hardware, training staff, and ongoing maintenance costs. Small and rural
healthcare practices may find it particularly challenging to bear these expenses.
Interoperability:
• The lack of interoperability between different HIT systems and EHRs is a significant challenge.
• Healthcare facilities often use various systems that don't communicate effectively, leading to difficulties in exchanging
patient data and coordinating care.

Data Privacy and Security Concerns:

• Healthcare data contains sensitive information, making data privacy and security a significant concern.
• Healthcare organizations must comply with strict regulations like the Health Insurance Portability and Accountability Act
(HIPAA) in the United States, which adds complexity and cost to HIT implementation.
Resistance to Change:
• Healthcare professionals and staff might be resistant to adopting new technologies due to fear of disruption, concerns
about additional workload, or unfamiliarity with the new systems.

Lack of IT Skills and Training:

• Some healthcare providers and staff may lack the necessary IT skills and training to use HIT effectively.
• Proper training is essential to ensure that users can utilize the technology to its full potential.

Workflow Disruptions:
• Introducing HIT systems may lead to disruptions in existing workflows, causing temporary decreases in productivity and
efficiency during the transition period.

Standardization and Regulation:

• The lack of standardized practices and guidelines across the healthcare industry can hinder the seamless integration and
implementation of HIT systems.

Limited Access to High-Speed Internet:

• In rural or underserved areas, limited access to high-speed internet can hinder the adoption of cloud-based HIT systems
and telemedicine services.
Vendor Lock-In:
• Healthcare organizations may face challenges in changing HIT vendors once they have implemented a particular system,
leading to vendor lock-in and potential difficulties in switching to more suitable solutions.

Financial Incentives:
• While some countries may offer financial incentives or reimbursement programs to encourage HIT adoption, the process of
qualifying and obtaining these incentives can be complex and time-consuming.

Fragmented Healthcare Landscape:

• In countries with multiple healthcare providers and payers, achieving uniformity and collaboration in HIT implementation can
be challenging.

Addressing these barriers requires collaboration between healthcare stakeholders, policymakers, and technology vendors to
develop strategies that promote HIT adoption, interoperability, and data security while considering the unique challenges faced
by different healthcare settings.