Implementing information and communication technologies (ICTs) in clinical care has proven to be a very difficult undertaking. While the potential gains from greater use of these technologies have been apparent for years, their use in the health sector lags way behind many other parts of the economy.
Five key questions arise:
- How can OECD countries reap efficiency and quality gains in the health sector through ICT?
- What are the main barriers to the introduction and effective use of ICT?
- What measures can ensure that an ICT initiative is carried through effectively?
- How can policy makers monitor and evaluate the impact of ICT?
- Do the “success stories” provide examples of best practice that can be used elsewhere?
Main results and conclusions
Case studies in six OECD countries (Australia, Canada, the Netherlands, Spain, Sweden and the United States) have helped identify the opportunities offered by ICTs to increase efficiency and quality-of-care. The OECD report ‘Improving Health Sector Efficiency :The Role of Information and Communication Technologies’ shows that there are a number of actions that governments can take for effective implementation of ICTs.
First, incentives act as key motivators in guiding implementation and effective use. A problem inhibiting the uptake of ICTs is how costs are distributed. Those who benefit from greater use of ICT are often not those who bear the costs of adoption. They are not the only factor determining adoption of ICTs, but financial incentives play an important role.
Privacy and liability issues are particularly sensitive in healthcare. Appropriate privacy protection must be incorporated into the design of new health ICT systems and policies from the outset, because it is often difficult or impossible to introduce effective privacy protections retroactively.
Effective system-wide exchange of medical information continues to be logistically difficult. While health care organisations have access to an ever increasing number of information technology products, their systems often cannot speak to each other, thus preventing the gains from sharing information. In addition, too often projects have been started without the clear systems that are needed to make progress, for instance, setting the objectives in terms of the health gains expected or introducing the appropriate workflow redesign, change management, education and training. This lack of governance is also reflected in the absence of reliable monitoring systems and good ways of assessing the effectiveness of the IT investments.
The case studies they illustrate that ICT can make significant improvements in health care delivery—reducing medical errors, improving clinical care through adherence to evidence-based guidelines, and preventing duplication and inefficiency in the delivery of clinical care.
ICTs are central to efforts to reorganise clinical care to face the new challenges of chronic disease management, allowing greater integration between primary and secondary care, and between health and social care. Electronic health records provide hope for improved reporting and assessment of clinical quality in the future.
Realising this potential will not happen by market forces alone. It requires aligning incentives, re-designing service delivery, and integrating providers into a common culture committed to quality of care, where ICT objectives are aligned with broader health system goals. When all of these components are in place, it is possible to find real gains in performance such as improved outcomes at lower costs.
For more recent information, see new work on the OECD Guide to Measuring ICTs in the Health Sector.
Read also the OECD Observer article E-ffective healthcare (©OECD Observer, No.278, March 2010).
Released in June 2010: Improving Health Sector Efficiency: The Role of Information and Communication Technologies, OECD Health Policy Studies, OECD, Paris.
Ms Elettra Ronchi, firstname.lastname@example.org.
Visit the OECD website to learn more about OECD work on health.
Improving Health Sector Efficiency