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AJMC Health IT Issue: It's Not the Systems, It's What You Do With Them


The annual health information technology issue (IT) of The American Journal of Managed Care looks at the purpose for the decade-long move away from paper to technology-based infrastructure: better delivery of care to populations. As special guest editor Dr. Joshua R. Vest and other authors note, there is progress, but we’re not there yet.


PLAINSBORO, N.J.—The point of health information technology (IT) isn’t the technology—it’s to change how we think about healthcare delivery, and by that measure there’s a long way to go, according to the annual special issue on health IT published by The American Journal of Managed Care.

Starting with a commentary led by special guest editor Joshua R. Vest, PhD, MPH, “Getting From Here to There: IT Needs for Population Health,” the issue gets to the heart of the reason for health IT in the first place: technology doesn’t exist for its own sake, but to move away from delivery care one individual at a time and instead to populations, so that health systems can quickly identify patterns, remove variation and inefficiency, improve quality, and lower costs.

To maximize the opportunities of technology, Vest and his co-authors write, health systems must be bolder and must do it quickly. “Opportunities exist to align health IT resources and population health management strategies to fill the gaps among technological capabilities, use and emerging demands of population health,” they write. “To realize this alignment, healthcare leaders must think differently about the types of data their organizations need, the types of partners with whom they share information, and how they can leverage new evidence based partnerships for evidence-based action.”

Other articles in the issue show that while there are health IT successes, there is a growing gulf between the leaders and those lagging behind:

· A. Jay Holmgren, BA; Vaishali Patel, PhD; Dustin Charles, MPH; and Julia Adler-Milstein, PhD, write that 21 percent of US hospitals were engaged in all four domains of interoperability, while 25 percent were engaged in none. The 21 percent engaged in all four were most likely to participate in delivery system reform. This gap has serious implications as providers prepare to comply with the Medicare Access and CHIP Reauthorization Act (MACRA).

· A study led by Christopher A. Harle, PhD, found that patient-reported outcomes about noncancer pain in electronic health records (EHR) made no difference in patient or provider experiences, but technological innovations could lead to better care.

· A study by a team from Johns Hopkins Bloomberg School of Public Health showed that Item Response Theory could offer useful tools for policymakers implementing EHR. Among their findings: besides costs, a major barrier to successful uptake is “obtaining physician cooperation.”

· On the positive side, Massachusetts is using health IT to monitor its HIV population, 86 percent of whom have achieved viral suppression. The goal is to use health IT to carefully track the care continuum and identify gaps to avoid transmission, with a long-term goal of eliminating new infections.

About the Journals and AJMC.com

The American Journal of Managed Care is the leading peer-reviewed journal dedicated to issues in managed care. AJMC.com distributes healthcare news to leading stakeholders across a variety of platforms. Other titles in the franchise include The American Journal of Accountable Care, which publishes research and commentary on innovative healthcare delivery models facilitated by the 2010 Affordable Care Act. AJMC’s Evidence-Based series brings together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.

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