2 Belief in the catalytic potential of HIT stems back at least a decade being first articulated in the US Department of Health and Human Services “Decade of Health Information Technology” report and President George W. 3Ī related and often deeply intertwined strand of policy discussion has been on using health information technology (HIT) to help achieve reform. The “triple aim” of healthcare reform provides helpful foci for reform efforts, namely: i) improving the quality, safety, and experience of care ii) enhancing population health and iii) reducing per capita costs of healthcare. 1, 2 In the face of these challenges, there is widespread agreement on the urgent need for health system reform. Health systems globally face challenges associated with, among other issues, rapidly changing demographic profiles, the increasing numbers of people living with long-term conditions, persistent variations in the quality and safety of care, and the spiraling costs of healthcare provision. Bush, State of the Union Address, January 20, 2004 “By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care.” Reform efforts are however severely limited by problems with usability, limited interoperability and the persistence of the fee-for-service paradigm-addressing these issues therefore needs to be the federal government’s main policy target. Early experiences indicate that the resulting digital infrastructure is being used to improve quality of care and curtail costs. Many underscored the need to “kick the legs from underneath the fee-for-service model” and replace it with a data-driven reimbursement system that rewards high quality care.Ĭonclusions The HITECH Act has stimulated unprecedented, multi-stakeholder interest in HIT. Proposed strategies for enhancing the benefits of HIT included federal stimulation of competition by mandating vendors to open-up their application program interfaces, incenting development of low-cost consumer informatics tools, and promoting Congressional review of the The Health Insurance Portability and Accountability Act (HIPPA) to optimize the balance between data privacy and reuse. There were however major concerns about the poor usability of electronic health records (EHRs), their limited ability to support multi-disciplinary care, and major difficulties with health information exchange, which undermined efforts to deliver integrated patient-centered care. There was a widely shared belief that Health Information Technology for Economic and Clinical Health (HITECH) had catalyzed the creation of a digital infrastructure, which was being used in innovative ways to improve quality of care and curtail costs. Results The authors undertook 47 interviews. Materials and methods In-depth qualitative interviews with federal government employees, health policy, HIT and medico-legal experts, health providers, physicians, purchasers, payers, patient advocates, and vendors from across the United States. Objective To investigate experiences with leveraging health information technology (HIT) to improve patient care and population health, and reduce healthcare expenditures.

Triple aim healthcare reform