Health Information Technology


Article Author:
Maxwell Jen


Article Editor:
Scott Korvek


Editors In Chief:
Jeffrey Nielson
Scott Rudkin
Scott Korvek


Managing Editors:
Orawan Chaigasame
Carrie Smith
Abdul Waheed
Frank Smeeks
Kristina Soman-Faulkner
Benjamin Eovaldi
Radia Jamil
Sobhan Daneshfar
Saad Nazir
William Gossman
Pritesh Sheth
Hassam Zulfiqar
Navid Mahabadi
Steve Bhimji
John Shell
Matthew Varacallo
Ahmad Malik
Mark Pellegrini
James Hughes
Beata Beatty
Hajira Basit
Phillip Hynes


Updated:
6/18/2019 5:07:11 AM

Introduction

Health information technology (HIT) is the hardware, software, and systems that comprise the input, transmission, use, extraction, and analysis of information in the healthcare sector. The end-users of this technology include not only patients, physicians, and other front-line healthcare providers, but also medical researchers, healthcare insurance companies, public health agencies, regulatory and quality assurance entities, pharmaceutical and medical device corporations, and various levels of government. Because these entities assume a huge range of roles and have such varied needs and goals, the technology and systems that underlie HIT are, at the societal scale, critical to the delivery and advancement of healthcare.[1][2][3]

Function

Functions and Goals of Healthcare Information Technology

The push for the development of HIT was borne from the belief that HIT would improve accountability, patient and population health outcomes, and healthcare delivery efficiencies while augmenting the ongoing effort to decrease healthcare costs.[4][5][6][7]

Increased Accountability

By digitizing healthcare data, HIT improves the ease with which the data can be abstracted and reviewed by medical centers, governmental agencies, and other interested entities. Previously, with paper records, data was frequently uninterpretable, illegible, lost, and/or incomplete. As a result, the analysis and insights that could be derived were limited. With HIT, not only is data digitized, but can also be automatically sorted, structured, and presented in ways (i.e., dashboard, graphs, figures) that provide meaningful real-time actionable insights. For instance, the NEDOCS score is a real-time measure of emergency department (ED) overcrowding. This is important to patient care as overcrowding has been linked to poorer patient care outcomes as well as poorer patient satisfaction. The NEDOCS score requires real-time variables (e.g., number of ED patients, the number of critical care patients, number of inpatient beds, etc.) for accurate calculation. With HIT, the required inputs can be automatically determined and thus, a minute-to-minute NEDOCS score can be calculated and thus hold administrators responsible not only for developing and implementing surge plans in the setting of overcrowding but also developing long-term, evidence-based plans for hospital staffing or expansion.

Improved Patient and Population Health Outcomes

Tools and applications can be built into HIT systems to address safety and outcome issues within patient care and population health. One prominent example is computerized physician order entry (CPOE). A product of HIT advances, CPOE has been touted as a major tool in the movement towards better patient care. In fact, in 2001, the Institute of Medicine, recognizing the importance of digital rather than written orders, called for the universal adoption of CPOE within all US healthcare institutions by 2010. Traditional paper orders carry multiple risks: writing an inappropriate dosage, writing for a medication to which a patient is allergic, and illegibility, to name a few. With appropriate programming, a HIT can flag these potential errors at the time of order entry, thereby decreasing medication errors, a major contributor to morbidity. On the population level, HIT tools range from biosurveillance (i.e., early warning systems for infectious disease outbreaks) to routine health screening reminders to chronic disease monitoring to medical research. One of the most prominent examples of HIT detection of disease in recent memory was the outbreak of lead poisoning caused by the Flint water crisis of 2014 to 2015 in Flint, Michigan. Due to a water supply switch, the citizens of Flint, Michigan began suffering from a variety of maladies; however, for more than a year, public officials denied any issues with the water supply stating that it was safe for public consumption. A study performed by Dr. Mona Hanna-Attisha, utilizing electronic medical record data (EMR) combined with geographic information software (GIS) concluded that the Flint water supply was heavily contaminated with lead and had resulted in thousands of cases of lead poisoning. Her findings directly lead to the first acknowledgments of the lead poisoning as well as subsequent state and federal measures to address the crisis.

Better Healthcare Delivery Efficiencies

In addition to patient-care benefits, HIT is also thought to improve the efficiency of delivering healthcare services. Some of the smaller yet still meaningful changes included improved coordination and scheduling of care and decreased administrative bureaucracy. However, improved communication through HIT systems is hoped to have an even more meaningful impact. One of the challenges of delivering healthcare efficiently is having necessary data in-hand at the right time. Because healthcare in the United States is largely fractured between competing groups of healthcare systems, private practice specialists, and hospitals, information such as test results and medical histories is often not transmitted between these entities in an efficient and timely manner. As a result, when a patient seeks services outside of his or her primary healthcare system, requests for information must be processed, and tests repeated to determine the appropriate service to deliver. In the previous era of paper records, this challenge was even greater as information even within the patient’s own medical system had to be retrieved from a file archive. With EMRs now widespread, data within an organization can now be retrieved from an electronic data warehouse instantaneously. Unfortunately, data transfer across systems has remained a challenge; EMRs across the various providers generally cannot send information electronically. Currently, efforts are underway to build out robust healthcare information exchange (HIE) networks to facilitate the retrieval of patient information generated at another provider or health system independently of the specific home EHR platform or vendor. In another step advancing this cause, the healthcare standards organization Health Level Seven International (HL7) in 2014 proposed Fast Healthcare Interoperability Resources (FHIR), a proposed set of software and programming standards that would standardize EMR and associated HIT software for the purpose of universal interoperability.   Outside the hospital, health insurance companies can also take advantage of these systems to improve their practices. With digitally transmitted data comes faster and more complete processing of claims. Furthermore, HIT-software can now analyze claims data which improves actuarial calculations, comparisons of cost-effectiveness between institutions, and also helps to better detect cases of healthcare insurance fraud.

Decreased Healthcare Costs

One of the most important issues of modern times, rising healthcare costs threaten to undermine the national economy (currently, more than $1 of every $6 in the United States (US) economy is spent on healthcare) as well as other societal priorities such as education, military, and social services. Though not a cure-all, HIT is thought to decrease costs via all the methods described above: increased operational efficiencies, improved patient safety, and better chronic disease management. According to a 2005 RAND Corp. analysis, the savings achieved in improved operational efficiencies alone could amount to $77 billion annually.[8][9]

Issues of Concern

Cost of Implementation

The primary challenge towards full adoption of HIT is the astronomical implementation cost. For EMR systems alone, such as those sold by the companies EPIC and Cerner Corp, can cost a small-to-medium-d hospital tens of millions of dollars, which may be unaffordable. The subsequent workflow changes, personnel training, associated software applications, and hospital infrastructure upgrades (e.g., additional computer and computer accessory purchases, Wi-Fi expansion, IT department expansion) represent additional costs. The subsequent learning curve leads to decreased productivity, at least temporarily which can result in decreased revenues following the expensive purchase.

Technologic Iatrogenesis

Though HIT may solve many problems, it will likely give rise to a new generation of problems. For example, data security, a smaller issue when healthcare organizations were primarily using paper charts because the amount of data one could steal was limited by how much one could physically carry without getting caught, becomes a very significant issue in a world in which corporate data breaches happen on a regular basis. At least one high-profile case of a hospital data breach occurred in February of 2016 when Hollywood Presbyterian Hospital in Hollywood, California became the victim of a ransomware attack. Its EMR and computer systems were locked down by hackers who would only release the lockdown if a ransom was paid. Since all hospital operations run through the EMR, for example, labs, billing, medical records, communications, this digital attack posed a life-threatening risk to the hospital’s patients. Another new problem that has arisen as a result of HIT is the decrease in productivity. Studies have demonstrated that working through an EMR is slower than with paper and pen. Additionally, the EMRs, in general, have typically succumbed to the problem of flashing too many warnings, many of them irrelevant similar to the problem of cardiac monitors giving too many false alarms. The general lack of specificity characterizing the both the EMR warnings and cardiac monitors both slows workflow and also increases the tendency to ignore warnings even when they are relevant.

Clinical Significance

Health Information Technology plays a role in improving health outcomes, quality of care, and the health care experience of patients, for example:

  • Allows access up-to-date evidence-based clinical guidelines and resources
  • Improves quality of care and patient safety
  • Assists patients in health maintenance
  • Coordinates care with multiple providers
  • Assists in sharing of clinical information
  • Relieves providers of paper-based referral process that burden practices and organizations.

Interested in Participating?

We are looking for contributors to author, edit, and peer review our vast library of review articles and multiple choice questions. In as little as 2-3 hours you can make a significant contribution to your specialty. In return for a small amount of your time, you will receive free access to all content and you will be published as an author or editor in eBooks, apps, online CME/CE activities, and an online Learning Management System for students, teachers, and program directors that allows access to review materials in over 500 specialties.

Improve Content - Become an Author or Editor

This is an academic project designed to provide inexpensive peer-reviewed Apps, eBooks, and very soon an online CME/CE system to help students identify weaknesses and improve knowledge. We would like you to consider being an author or editor. Please click here to learn more. Thank you for you for your interest, the StatPearls Publishing Editorial Team.

Health Information Technology - Questions

Take a quiz of the questions on this article.

Take Quiz
Which of the following is TRUE of the Office of the National Coordinator for Health Information Technology?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following is NOT included in the Office of the National Coordinator for Health Information Technology's (ONC's) mission?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following is NOT among the Office of the National Coordinator for Health Information Technology's (ONC's) expectations of promoting the development of a nationwide Health IT infrastructure that allows for electronic use and exchange of information?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following statements is among the Office of the National Coordinator for Health Information Technology's (ONC's) mission of promoting the development of a nationwide Health IT infrastructure that allows for electronic use and exchange of information?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following does not describe an aspect of the Office of the National Coordinator for Health Information Technology's (ONC's) mission?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following of these Office of the National Coordinator for Health Information Technology (ONC) initiatives serves the needs of a diverse array of stakeholders to foster health IT adoption?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following does NOT apply to the nationwide health information network (NHIN)?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following are among the requirements for participating in the Nationwide Health Information Network (NHIN) Exchange?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following is the EXCEPTION to the uses of the Nationwide Health Information Network (NHIN)?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following is the EXCEPTION to the Nationwide Health Information Network activities (NHIN)?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following of CONNECT is TRUE?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following is NOT a method the Office of the National Coordinator for Health Information Technology (ONC) has used to include public input in the development of the health information infrastructure as mandated by Congress?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following is the EXCEPTION to methods for entering data into the Veterans Information Systems and Technology Architecture (VistA)?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following is the best description of Information Technology?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of these BEST describes Integrating the Healthcare Enterprise (IHE)?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following is among the competencies required of Healthcare Information Technologists (HITs)?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up
Which of the following represents the transmission of healthcare-related data among facilities, health information organizations (HIO), and government agencies according to national standards?



Click Your Answer Below


Would you like to access teaching points and more information on this topic?

Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.

Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.


Sign Up

Health Information Technology - References

References

Liu J,Sakarovitch C,Sigurdson K,Lee HC,Profit J, Disparities in Health Care-Associated Infections in the NICU. American journal of perinatology. 2019 Apr 30;     [PubMed]
Herout J,Baggetta D,Cournoyer A,Dietz AS,Robbins J,Maddox K,Dobre J, Potential impact of data source and interoperability messaging on health information technology (HIT) users: a study series from the United States Department of Veterans Affairs. BMJ health     [PubMed]
Norell Pejner M,Ourique de Morais W,Lundström J,Laurell H,Skärsäter I, A Smart Home System for Information Sharing, Health Assessments, and Medication Self-Management for Older People: Protocol for a Mixed-Methods Study. JMIR research protocols. 2019 Apr 30;     [PubMed]
Silverman HD,Steen EB,Carpenito JN,Ondrula CJ,Williamson JJ,Fridsma DB, Domains, tasks, and knowledge for clinical informatics subspecialty practice: results of a practice analysis. Journal of the American Medical Informatics Association : JAMIA. 2019 Apr 30;     [PubMed]
Atkinson KM,Wilson K,Murphy MSQ,El-Halabi S,Kahale LA,Laflamme LL,El-Khatib Z, Effectiveness of digital technologies at improving vaccine uptake and series completion - A systematic review and meta-analysis of randomized controlled trials. Vaccine. 2019 Apr 26;     [PubMed]
Leviton A,Oppenheimer J,Chiujdea M,Antonetty A,Ojo OW,Garcia S,Weas S,Fleegler E,Chan E,Loddenkemper T, Characteristics of Future Models of Integrated Outpatient Care. Healthcare (Basel, Switzerland). 2019 Apr 27;     [PubMed]
Yousaf K,Mehmood Z,Saba T,Rehman A,Munshi AM,Alharbey R,Rashid M, Mobile-Health Applications for the Efficient Delivery of Health Care Facility to People with Dementia (PwD) and Support to Their Carers: A Survey. BioMed research international. 2019;     [PubMed]
Yoshida Y,Boren SA,Soares J,Popescu M,Nielson SD,Koopman RJ,Kennedy DR,Simoes EJ, Effect of Health Information Technologies on Cardiovascular Risk Factors among Patients with Diabetes. Current diabetes reports. 2019 Apr 27;     [PubMed]
Russo P,Rosano GMC,Favato G,Staniscia T,Romano F, Cost-effectiveness of direct acting oral anticoagulants in the prevention of thromboembolic complications: limits and concerns of economic evaluations. Journal of cardiovascular medicine (Hagerstown, Md.). 2019 Apr 25;     [PubMed]

Disclaimer

The intent of StatPearls is to provide practice questions and explanations to assist you in identifying and resolving knowledge deficits. These questions and explanations are not intended to be a source of the knowledge base of all of medicine, nor is it intended to be a board or certification review of Clinical-Informatics. The authors or editors do not warrant the information is complete or accurate. The reader is encouraged to verify each answer and explanation in several references. All drug indications and dosages should be verified before administration.

StatPearls offers the most comprehensive database of free multiple-choice questions with explanations and short review chapters ever developed. This system helps physicians, medical students, dentists, nurses, pharmacists, and allied health professionals identify education deficits and learn new concepts. StatPearls is not a board or certification review system for Clinical-Informatics, it is a learning system that you can use to help improve your knowledge base of medicine for life-long learning. StatPearls will help you identify your weaknesses so that when you are ready to study for a board or certification exam in Clinical-Informatics, you will already be prepared.

Our content is updated continuously through a multi-step peer review process that will help you be prepared and review for a thorough knowledge of Clinical-Informatics. When it is time for the Clinical-Informatics board and certification exam, you will already be ready. Besides online study quizzes, we also publish our peer-reviewed content in eBooks and mobile Apps. We also offer inexpensive CME/CE, so our content can be used to attain education credits while you study Clinical-Informatics.