IOM Report 1/9/09 - Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions

IOM Report 1/9/09 - Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions

Robert S. Miller, FASCO

Jan 10, 2009

Wow, hot off the presses today is a landmark report from the National Research Council of the IOM/National Academies. As I post this I have just read the Executive Summary (the whole report is available here), but what this appears to be is both a condemnation of the current vendor-centric, business app-oriented and often clinically irrelevant HIT implementations prevalent in many hospitals today and a vision for the future of how HIT can serve quality patient care better. It was authored by a lot of heavy hitters including William Stead of Vanderbilt and Octo Barnett of MGH, so I think this one will have a lot of impact. Here is an excerpt as summarized by the blog HIS Talk:

"IT related activities of health professionals observed by the committee in these institutions were rarely integrated into clinical practice. Health care IT was rarely used to provide clinicians with evidence-based decision support and feedback; to support data-driven process improvement; or to link clinical care and research. Health care IT rarely provided an integrative view of patient data. Care providers spent a great deal of time electronically documenting what they did for patients, but these providers often said they were entering the information to comply with regulations or to defend against lawsuits, rather than because they expected someone to use it to improve clinical care. Health care IT implementation time lines were often measured in decades, and most systems were poorly or incompletely integrated into practice. Although the use of health care IT is an integral element of health care in the 21st century, the current focus of the health care IT efforts that the committee observer is not sufficient to drive the kind of change in health care that is truly needed. The nation faces a health care IT chasm that is analogous to the quality chasm highlighted by the IOM over the past decade."

HIS Talk also does a nice summary of the salient points here.

It is hardly accidental wording that IOM in this report speaks about the "health care IT chasm." I am looking forward to reading the whole thing. I hope we can have some good discussion from the participants in this forum.



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