EHR adoption "in its infancy"
Pamela McNutt, senior vice president/CIO at Dallas-based Methodist Health System, says HIT advocates were a little naïve early in the process.
"There was a bit of over-simplistic thought that if we just purchased and installed some software that suddenly everyone would start connecting and talking and it is premature," McNutt says. "Even people who have met high levels and are ready to meet Meaningful Use Stage 2 still have to work to get efficiencies."
"Adoption is happening, but it is still in its infancy," she says. "It is not mature, even for people who've met meaningful use Stage 1. That is the reason there are stages, they bring us to different levels of maturity. And this whole healthcare information exchange idea is also in its infancy. We haven't had enough time to see the impact. We do need organizational change. Things like shared-savings programs, medical homes that are going to drive the change from different directions. We are getting there but we aren't there. But nobody should be looking at this and saying it didn't work."
McNutt says the whole idea of "efficiencies" in HIT is a bit undefined. "We have to talk about what are the efficiencies we are looking for," she says.
"I don't think anyone went into this thinking that this would cut hours out of doctors' and nurses' time every day. But are we going to get better outcomes, less complications, less morbidity and mortality. That all adds up to dollar savings in a different kind of way, but I don't think I'd call that efficiency."
McNutt says using HIT to reduce costs won't happen until it can be done on a population health basis.
"When records from all providers, post-acute, acute, pharmaceutical, when all of that can be put into a usable record, that is where we might begin to have some savings," she says.
"But the RAND study does make a point that probably is true—that even if you have all the tools in the world to see what is going on in the patient you have to change your work flow to use the information from those tools."