History of Health Information

Technology in the U.S.

Evolution of Health IT: The Modern Era
Lecture b Key Stakeholders

This material Comp5_Unit2 was developed by The University of Alabama Birmingham, funded by the Department of Health and Human
Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000023
Evolution of Health IT:
The Modern Era
Learning Objectives
2
Discuss factors that led to increasing clinical use of
computers from 1990 to 2009
Discuss key influences on health IT developments
including the Internet, HIPAA, and the Institute of
Medicine reports
Discuss the focus of health IT in the late 90s up to the
present
Discuss the role of health IT in clinical and translational
research and personalized medicine
Discuss why there is more receptivity to the use of health
IT now than during the previous 50 years
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Healthcare Organizations
Increase revenue and decrease costs
Increase in use of administrative DSS

3
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Healthcare Organizations
Increase revenue and decrease costs
Increase in use of administrative DSS
Increase quality
Quality improvement methods
Outcomes analysis
Guidelines, critical pathways, protocols
Increase use of clinical DSS

4
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Healthcare Organizations
Increase revenue and decrease costs
Increase in use of administrative DSS
Increase quality
Quality improvement methods
Outcomes analysis
Guidelines, critical pathways, protocols
Increase use of clinical DSS
Chief Information Officer

5
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Healthcare Organizations
Increase revenue and decrease costs
Increase in use of administrative DSS
Increase quality
Quality improvement methods
Outcomes analysis
Guidelines, critical pathways, protocols
Increase use of clinical DSS
Chief Information Officer
Chief Medical/Nursing Information
Officer

6
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Physicians
Group practice, salaried positions
More knowledgeable patients
Further decrease in physician authority







Source: (Cohen & Adams, 2009)



7
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Physicians
Group practice, salaried positions
More knowledgeable patients
Further decrease in physician authority
Practice location shift
Outpatient
Hospitalists



Source: (Wachter & Goldman, 2002)
8
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Physicians
Group practice, salaried positions
More knowledgeable patients
Further decrease in physician authority
Practice location shift
Outpatient
Hospitalists
Use of computer for information
Little use of the computer for information
management until recently
9
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Physicians
Group practice, salaried positions
More knowledgeable patients
Further decrease in physician authority
Practice location shift
Outpatient
Hospitalists
Use of computer for information
Little use of the computer for information
management until recently
Increased acceptance of standardization
Increase in clinical computing
10
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Academic Physicians
Increased pressure for revenue generation
Decreased time for teaching
Computer to increase instructional efficiency
Increase in business partnerships

11
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Academic Physicians
Increased pressure for revenue generation
Decreased time for teaching
Computer to increase instructional efficiency
Increase in business partnerships
Evidence-based medicine
Use of literature in practice
Outcomes and comparative effectiveness
research

Source: (Sackett et al., 1996)

12
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Academic Physicians
Increased pressure for revenue generation
Decreased time for teaching
Computer to increase instructional efficiency
Increase in business partnerships
Evidence-based medicine
Use of literature in practice
Outcomes and comparative effectiveness research
Health services research on quality of care
and information technology

13
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Academic Informaticians
Decision support systems
Computer-based patient records
Clinical repositories/warehouses
Standardized clinical vocabularies/terminologies





Source: (Humphreys et al., 1998)




14
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Academic Informaticians
Decision support systems
Computer-based patient records
Clinical repositories/warehouses
Standardized clinical vocabularies/terminologies
Increased professional specialization
Nursing, dental informatics, etc.
Professional journals
Training programs
Certification

15
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Academic Informaticians
Decision support systems
Computer-based patient records
Clinical repositories/warehouses
Standardized clinical vocabularies/terminologies
Increased professional specialization
Nursing, dental informatics, etc.
Professional journals
Training programs
Certification
Integration into healthcare delivery
Increased involvement with vendors

16
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Information Technology
More information needs
Monitor cost, quality and patient
satisfaction
Influence clinical practice
17
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Information Technology
More information needs
Monitor cost, quality and patient satisfaction
Influence clinical practice
Increased importance of information
technology in healthcare


18
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Information Technology
More information needs
Monitor cost, quality and patient satisfaction
Influence clinical practice
Increased importance of information
technology in healthcare
Greater recognition at the federal level


19
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Why Now?
20
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Change in
Environment
Attitudes
Values
21
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Convergence of Needs

22
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Convergence of Needs
23
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Convergence of Needs
24
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Convergence of Needs
25
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Convergence of Needs
26
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
Evolution of Health IT:
The Modern Era
Summary
Changes in healthcare environment since
the 1990s
Environmental influences on professional
groups
Development of technology
More receptivity to health IT
27
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b
References
References
Cohen RA, Adams PF. Use of the Internet for health information: United States, 2009. NCHS Data Brief Number
66. 2011 July. Available from: http://www.cdc.gov/nchs/data/databriefs/db66.htm
Humphreys BL, Lindberg DA, Schoolman HM, Barnett GO. The Unified Medical Language System: an informatics
research collaboration. J Am Med Inform Assoc. 1998 Jan-Feb;5(1):1-11.
Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence based medicine: what it is and
what it isnt. BMJ. 1996;312:71.
Wachter RM, Goldman L. The hospitalist movement 5 years later. JAMA. 2002;287(4):487-94.



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Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Health IT: The Modern Era
Lecture b