The new report, funded by the U.S. Agency for Healthcare Research and Quality (AHRQ), looked at studies that have examined the impact of health-care technology on the quality of health care, as well as the costs and organizational changes needed to implement information technology systems for heath care for the smaller medical practices and hospitals that constitute the majority of the nation's health care providers.
A previous Rand study reported that wide spread adoption of electronic medical records and other health information technology could improve the quality of medical care and save more than $81 billion annually.
"Computer storage of medical records has already transformed patient care and research within institutions by providing instant access to the patient data needed to manage and study patients' acute (immediate) medical problems," said Regenstrief Institute Director Clement J. McDonald, M.D., Distinguished Professor and professor of medicine at the Indiana University School of Medicine. "The next step is to provide the same access across institutions to provide the same capabilities wherever the patient presents for care in order to improve prevention and the care of chronic (long term) medical conditions."
Over the past three decades, the institute's research scientists have developed the Regenstrief Medical Records System. Over 32 million physician orders have been entered into the computerized order entry system of the RMRS that provides unique clinical decision support and guidelines. RMRS has a database of 3 million patients, with 900 million discrete, on-line results, 16 million text reports including diagnostic studies, procedure results, operative notes, discharge summaries, and 50 million radiology images.
The RMRS serves as the day-to-day electronic medical records system at a 319-bed public hospital and its community clinics. Regenstrief's informaticians have created the Indiana Network for Patient Care, the nation's oldest and largest regional electronic medical records system covering 15 hospitals in central Indiana which allows physicians caring for the patient, to view as a single virtual record much of a patient's previous care.
Building upon RMRS and INPC, the Indiana Health Information Exchange, Inc., a non-profit corporation for sharing clinical information among health-care providers and other health care entities is dedicated to improving the quality, safety and efficiency of health care in the state of Indiana.
Regenstrief's informatics group also has pioneered international electronic message standards for medical records including the development of HL7, the standard for electronic data interchange in health care. They have developed the Logical Observation Identifiers Names and Codes (LOINC©) system, a standard nomenclature (currently over 41,000 observation terms) that enables the electronic transmission of clinical data from laboratories to hospitals, physicians' offices and payers for clinical care and management purposes.
Regenstrief informatics studies have been published in the New England Journal of Medicine, Journal of the American Medical Association, the Journal of the American Medical Informatics Association and numerous other peer reviewed journals.
Dr. McDonald, who has led the institute's informatics physician brain trust for over 30 years, and Regenstrief Institute Research Scientist J. Marc Overhage, M.D., Ph.D., Indiana University professor of medicine and president & CEO of IHIE, are available to discuss adoption of information technology by health-care providers.
- The Rand Report can be downloaded at http://www.
ahrq. gov/ downloads/ pub/ evidence/ pdf/ hitsyscosts/ hitsys.
- An interactive database providing access to the studies reviewed as part of the report is available at http://www.
healthit. ahrq. gov/ tools/ rand
- An article summarizing the report will be published in the May 16 edition of Annals of Internal Medicine. http://www.
annals. org/ cgi/ content/ full/ 0000605-200605160-00125v1