Harvard Research Reports: Health IT Lacks Inefficiency and Savings

According to the Harvard researchers, the increased computerization in U.S. hospitals hasn't made them cheaper or more efficient, although it may have modestly improved the quality of care for heart attacks.

The findings, published online edition of the American Journal of Medicine, contradict claims by President Obama and many lawmakers that health IT, including electronic medical records, will save billions and help make reform affordable.

David Himmelstein, associate professor at Harvard Medical School, former director of clinical computing at Cambridge Hospital in Massachusetts and lead author of the report said that the study finds that hospital computerization hasn't saved a dime, nor has it improved administrative efficiency.

 

:Claims that health IT will slash costs and help pay for the reforms being debated in Congress are wishful thinking,” Himmelstein said.

The study uses data survey on hospital computerization. Data from approximately 4,000 hospitals for the years 2003 to 2007, including those on a list of the 100 Most Wired, were analyzed.

The data came from the authoritative Healthcare Information and Management Systems Society, or “HIMSS,” Analytics annual survey of hospital computerization; Medicare Cost Reports that virtually all hospitals submit annually to the Centers for Medicare and Medicaid Services and the 2008 Dartmouth Health Atlas, which compiles CMS data on costs and quality of care.

The report says that U.S. hospitals increased their computerization between 2003 and 2007, and found no indication that health IT lowered costs or enhanced administration, even in the most wired institutions. While U.S. hospital administrative costs increased, from 24.4 percent in 2003 to 24.9 percent in 2007, hospitals that computerized most rapidly bigger increases in administrative costs.

Some quality gains were seen in the treatment of heart attacks in more-computerized hospitals, but these small improvements may merely represent better documentation rather than actual gains to patients.

Himmelstein said a report from the Congressional Budget Office in 2008 signed by Peter Orszag, now Obama's budget director, expressed skepticism about claims by the RAND Corp. and others that health IT could generate $80 billion annually in savings.

“Part of the CBO's skepticism was based on the limited information available to the RAND study and similar studies,” Himmelstein added. “But this new, detailed, national survey of diverse hospitals shows such doubts are well-founded. Information technology can't rescue us from our national health care crisis.”

Dr. Steffie Woolhandler, professor of medicine at Harvard and study co-author, said that any savings may have been offset by the costs of purchasing and running new computer systems.

 

“In addition, most software is designed around the accounting and billing needs of hospitals, not the clinical side,” Woolhandler said.

“The VA system now has our nation's highest quality and patient approval ratings,” Woolhandler adds. “Congress should take note: to get the most benefit from our health care dollars and from health IT, we should adopt a single-payer, Medicare-for-all program. Nothing short of that will allow us to reap the full potential of computerization or to provide comprehensive, quality and affordable care to all.”