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People no longer go to their doctor first to solve their healthcare questions. They go to the Internet. The Pew Internet and American Life Project found that 83 percent of Internet users search to find health information. Could a wave of innovation in health information technology, or HIT, from Internet software to electronic health records, be a key driver of reducing costs and improving healthcare quality in America?

Leaders from the public and private sector certainly believe this to be true. Private companies are now marketing Internet healthcare options to consumers to increase patient access to personal health information. Similarly, innovation around electronic patient health information technology is already helping physicians treat their patients at both public and private medical facilities. With greater access to health information, the doctor and patient can more easily manage and coordinate care, improving patient health while also reducing the chance of medical error and duplicative servicing.

Public policy initiatives are already accelerating the deployment of HIT in medical centers throughout the country. Congress passed the Health Information Technology for Economic and Clinical Health Act as part of the American Recovery and Reinvestment Act in February of 2009, allotting $19 billion to be used to establish effective HIT services within healthcare centers. In March 2010, Congress pledged its commitment to technological innovations within the Patient Protection and Affordable Care Act by specifying quality and privacy standards for IT devices. The Office of the National Coordinator for HIT, also established by the HITECH Act, will lead efforts to implement HIT across the country and establish infrastructure to support the sustainable use of these new technologies.

These policy initiatives are not lost on the private sector. We’ve also seen the beginnings of corporate investment in health information technology innovation and commercialization in recent years. Companies such as Microsoft Corp., Google Inc., and Apple Computer Corp. are all vying to develop and market consumer healthcare information services focused on improving physician and patient access to personal medical records.

Innovation in this area could not come at a better time. HIT has the potential to improve healthcare quality and reduce cost through various functions:

• Preventative care
• Population-level health management
• Chronic disease management
• Care coordination
• Nonvisit based care or e-care

Some of these information technology enabled healthcare functions are already being adopted by healthcare providers around the country. For instance, MedStar Health, a nonprofit, community-based healthcare organization, uses its electronic health record, or EHR system to monitor patient check-ups and preventative testing digitally. The system notifies doctors when patients are missing important testing services.

Electronic health records systems also have the potential to monitor populations’ health information in aggregate. Google.org, Google’s technology-driven philanthropy initiative, currently utilizes its technology to monitor flu activity around the world. By cross-referencing this information with data from Google’s popular mapping software, Google can assess whether the availability of flu vaccine clinics is sufficient to address the level of infection in regions around the world.

This information can be useful to local officials deciding where to allocate flu vaccination resources. The technology also can enable patients to locate vaccination clinics by using Google map’s Google Flu Vaccine Finder. Such technologies can increase the use of preventative procedures which could increase the health of the population and reduce the need for costly hospital services.

Doctors and health insurance companies are also using HIT to monitor chronic diseases. Kaiser Permanente, a nonprofit managed care organization and the nation’s largest health plan, utilized its EHR system to monitor cardiovascular patients in its Colorado center. With the help of the EHR system, the number of patients that reached their cardiovascular goals increased from 26 percent to 73 percent. Likewise, heart attack deaths fell by 73 percent.

Similar results were shown by Geisinger Health System, a nonprofit health maintenance organization in Pennsylvania, which uses its electronic health records system to coordinate care for its patients. Geisinger created a “virtual team,” including general practitioners, specialists, nurses, therapists, and a support staff, to monitor its patients via its electronic health system. By coordinating care, Geisinger was able to decrease unnecessary hospital usage, and patient discharges increased from 81 percent to 93 percent. What’s more, hospital readmissions decreased by 44 percent. This increase in quality of care can decrease hospital use and reduce costs that are associated with unnecessary medical services.

Lastly, health practitioners hope to see similar improvements with the nonvisit based health programs. In its Hawaii center, Kaiser Permanente utilizes “virtual visits” to interact with and treat patients via the Internet. And Portland’s Greenfield Clinic treats 80 percent of its patient’s needs via telephone or secure electronic messaging.

New initiatives are beginning to focus on e-prescribing methods as well as creating real-time interaction systems. Such e-healthcare models give patients greater access to physician’s medical guidance for mild health concerns that do not necessitate an in-person clinical interaction, cutting down on travel time and lost productivity. Patient health can increase by extending patients’ access to treatments, and expenditures associated with hospital use can decrease as a result of less hospital usage.

There is much more to come as we look into the future of healthcare innovations. As with all new technologies, initial adoption can be slow and costly due to the need to invest in infrastructure, and due to a lack of familiarity among consumers. But where there are clear societal benefits, public policy is justified in helping to facilitate innovation and kick start nascent industries. A study by RAND Corporation showed that implementation of HIT in the U.S. healthcare system would have enormous financial benefits. Reduced hospital stays, reduced nurses’ administrative time, and more efficient drug utilization could reduce inpatient and outpatient care service costs by approximately $77 billion each year, the study said.

The HITECH Act, and the Affordable Care Act are important first steps to helping realize these economic benefits. With funding from the HITECH Act, President Obama appointed Dr. David Blumenthal, a primary care physician and Professor of Medicine and Health Policy at the Harvard Medical School, as the National Coordinator for Health Information Technology. Dr. Blumenthal will spearhead a series of programs to accelerate the innovation and commercialization of HIT.

Starting with the Beacon Community Cooperative Agreement Program, the Office of National Coordinator for Health Information Technology will provide funding to selected communities to establish and strengthen HIT infrastructures and exchange capabilities. HITECH funds will also be used to establish a State Health Information Exchange Cooperative Agreement. Within this program, grants will be given to support states in establishing Health Information Exchange capabilities between providers and hospitals.

In addition, Health Information Technology Extension Programs will be designed to offer technical assistance to those adopting HIT systems. Finally, the Strategic HIT Advanced Research Projects Program and university-based training initiatives will ensure that health technology continues to advance and that there are qualified students who can operate health technology for emerging hospital systems.

Since much of the technology behind HIT is already well understood (Internet technology and electronic database management have been around for years), the biggest challenge in accelerating innovation will not be the need to conduct basic research but rather to speed deployment and drive demand. The majority of the $19 billion HITECH appropriations will be used to encourage healthcare providers to adopt HIT systems. Titled the EHR Incentive Programs, Centers for Medicare and Medicaid will financially reward practitioners that meet “meaningful use” criteria, meaning that their systems actually improve the quality of their patients’ health. The EHR program will give financial rewards to healthcare systems, ranging between $44,000 and $64,000 per physician and $11 million per hospital. These targeted financial incentives should fuel adoption of HIT systems and motivate cost savings.

Ultimately, public policy alone cannot create innovation; companies must step up to the plate to design and market new products and systems to help doctors, patients, and care providers increase efficiency and quality while cutting cost. Microsoft Health Vault, Google Health, and Apple’s iPhone’s personal health record systems give patients personal control over their healthcare information by putting the responsibility of preventative care treatments, care coordination, and chronic health management in the patient’s own hands. Personal health management will allow patients to monitor their health without physician assistance. Doing so can improve patient health and reduce costs associated with hospital visits. As noted in the RAND report, such cost decreases will contribute towards the $77 billion cost savings.

Although the benefits of HIT have been clearly noted, many scholars warn that new technology alone will not solve the U.S. health care system, and even $77 billion in savings is only a small fraction of the $1.7 trillion that is spent on healthcare each year in the United States. HIT will reduce cost if patients become healthier and need fewer services, yet the cost of implementing HIT systems and the cost of training HIT users will still exist. Moreover, structural market barriers remain in spite of the sweeping reform bill signed by President Obama this year.

Reimbursement systems still reward doctors for the quantity of their services rather than the quality of their patients’ health. This reduces the incentive for practitioners to adopt HIT systems that help keep patients out of the doctor’s office entirely. Until reimbursement mechanisms reward quality care, health providers may be reluctant to adopt HIT systems. This could put a damper on future corporate investment in HIT innovation because companies will only continue to invest in these technologies so long as they are confident of a future market for them. As previously mentioned, the EHR Incentives program tries to correct this gap in financial incentives by giving bonuses to physicians and hospitals who meet “meaning use” standards, but the U.S. healthcare system may need a more sustainable payment mechanism to encourage HIT innovation in the long run.

For now, then, the future results of HIT deployment remain unclear. What is certain though is that with increased adoption, these new technologies have the potential to save lives and benefit the economy. The passage of HITECH has brought us one step closer to seizing this potential, but more is needed. The main concern of public officials now must be to create HIT networks at the lowest possible cost while also encouraging physicians to adopt the new technology. This will result in benefits to the health of our national HIT innovation system, our economy more broadly, and of course, our people.

Jenay Davis is an intern with Science Progress and is a senior at the University of Pennsylvania.

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