Information and communications technology in U.S. health care: why is adoption so slow and is slower better?
Politicians across the political spectrum support greater investment in health care information and communications technology (ICT) and expect it to significantly decrease costs and improve health outcomes. We address three policy questions about adoption of ICT in health care: First, why is there s...
| Publicado en: | Journal of Health Politics, Policy & Law Vol. 34; no. 6; pp. 1011 - 1035 |
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| Autores principales: | , |
| Formato: | Journal Article |
| Publicado: |
Duke University Press
Dec2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105290665&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105290665 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03616878 HPP jtl: Journal of Health Politics, Policy & Law issn: 03616878 maglogo: N pubinfo: dt: Dec2009 vid: 34 iid: 6 pid: 154 pub: Duke University Press place: Durham, North Carolina artinfo: ui: 105290665 2010534640 10.1215/03616878-2009-034 NLM20018989 105290665 ppf: 1011 ppct: 24 formats: fmt: @attributes: type: P tig: atl: Information and communications technology in U.S. health care: why is adoption so slow and is slower better? aug: au: Christensen MC Remler D sug: subj: Diffusion of Innovation Health Informatics Health Policy United States Politics United States Electronic Order Entry Health Informatics Economics Health Informatics Standards Health Insurance Portability and Accountability Act Insurance, Health Internet Investments Patient Record Systems Economics Systems Integration United States United States Department of Veterans Affairs ab: Politicians across the political spectrum support greater investment in health care information and communications technology (ICT) and expect it to significantly decrease costs and improve health outcomes. We address three policy questions about adoption of ICT in health care: First, why is there so little adoption? Second, what policies will facilitate and accelerate adoption? Third, what is the best pace for adoption? We first describe the unusual economics of ICT, particularly network externalities, and then determine how those economics interact with and are exacerbated by the unusual economics of health care. High replacement costs and the need for technical compatibility are general barriers to ICT adoption and often result in lock-in to adopted technologies. These effects are compounded in health care because the markets for health care services, health insurance, and labor are interlinked. In addition, the government interacts with all markets in its role as an insurer. Patient heterogeneity further exacerbates these effects. Finally, ICT markets are often characterized by natural monopolies, resulting in little product diversity, an effect ill-suited to patient heterogeneity. The ongoing process for setting technical standards for health care ICT is critical but needs to include all relevant stakeholders, including patient groups. The process must be careful (i.e., slow), flexible, and allow for as much diversity as possible. We find that waiting to adopt ICT is a surprisingly wise policy. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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