As a family physician, Jon White dealt with mountains of paperwork every day. From charts to medical histories and prescriptions, each patient came with their own bundle of papers. Sometimes the script was illegible, and sometimes sheets would get lost. When he was on call and asked to consult on a case from home, White often couldn’t verify patient details since the files were back in the office. White thought there had to be a better way to address these challenges.
“I came to appreciate that in order to deliver great care, you need great information,” White said.
The idea led him into the burgeoning field of health-care information technology, which includes everything from electronic health records to tracking diseases like Zika or Ebola through population health data.
White eventually became deputy national coordinator for the Office of the National Coordinator for Health Information Technology, a federal organization that helps the health-care system implement and use technology.
White didn’t know it at the time, but his decision to pivot to health IT more than a decade ago foreshadowed a new era in health care.
Today health-care providers around the world spend more than $100 billion per year on health IT, an emerging field that includes electronic health records, online patient portals, health apps and personalized medicine. More than 45 percent of that spending comes from North America, according to research and advisory firm Gartner. With major market players like IBM, Cerner, GE Healthcare and many more embracing health IT, the global market is expected to increase at a rate of nearly 16 percent through 2022.
The rapid growth has brought with it a shift in the traditional roles of physicians like White, along with new jobs in health informatics. Many employers are no longer searching for just doctors and nurses. Now they need chief medical information officers, quality management officers and clinical analysts.
It is too early in the emerging sector for the Bureau of Labor Statistics to track health IT jobs yet, but it shows that the job outlook for health information technicians (involving digital and paper-based work) isprojected to grow 15 percent by 2024, much faster than most occupations. Jobs in computer and information technology in general are projected to increase 12 percent, with part of the growth coming from the health-care industry.
Fast-track adoption of electronic health records in hospitals and physician’s offices, fueled by the 2009 HITECH Act, paved the way for the rise of health IT.
In 2011, 71.9 percent of non-federal acute-care hospitals had adopted electronic health records that met the certified standards of the Department of Health and Human Services, according to HealthIT.gov. By 2014 that had risen to 96 percent of hospitals.
At their simplest, electronic health records are digital versions of patients’ paper medical charts, but they can also include a lot more information. In many places, electronic health records sync with health data from FitBits or smartphone apps. Some feature patient portals that allow individuals to access their medical history or schedule doctors’ appointments online.
Under the HITECH Act, incentive programs were developed to help health-care providers cover the cost of transitioning to electronic medical records. As of August 2016, more than 508,000 providers received nearly $35 billion through the Medicare and Medicaid incentive programs.
Today, 96 percent of hospitals and 78 percent of physicians use electronic health records. Nearly 7 in 10 hospitals give patients the ability to view and transmit their health information online.
The revenue opportunity
Hackensack University Medical Center in New Jersey is one of them. The hospital’s electronic system allows users to look up symptoms, find doctors, make appointments and review test results. It also links patient-generated data from personal fitness devices and mobile apps to electronic medical records.
The system allows the hospital to see one additional patient each hour and has increased hospital revenue by 17 to 25 percent, according to chief information officer Dr. Shafiq Rab. “It improved the workflow. It improved the quality of care,” he said. “It helped us to decrease bad outcomes. Hence, our revenue increase.”
White said positive revenue results have been seen at some hospitals, but other experts say it is still too early to conclude that electronic health records are definitively worth the cost of implementation. In some cases, adopting the digital system can decrease costs after three years, but in other cases — especially at smaller health systems — it can cause increased costs even after six years.
According to a 2016 Medscape report, 56 percent of physicians said electronic medical records improved their documentation process, but about an equal percentage said it decreases the amount of face-to-face interaction they get with patients and often reduces the number of patients they can see.
Many doctors say the increased computerization of the medical field is one of the leading causes of burnout. That speaks to a need for employers to help clinicians adapt to new technology, new workflows and, in some cases, even new jobs.