RAND Analysts Say Misaligned Incentives Hinder Interoperability

In 2005, several RAND Corporation researchers predicted that rapid adoption of electronic health records and health IT systems could save the greater U.S. healthcare system about $80 billion annually — not a huge amount of the $2 trillion spent that year, but worth it for the government and providers to invest money, labor and time.

Several years and billions in health IT spending later, two different RAND researchers argue in Health Affairs, those and other optimistic predictions of health IT’s benefits haven’t materialized broadly among health systems, due in large part to a “lack of progress on interoperability.”

Interoperability, easy-to-use digital record keeping and inter-institutional communication were largely assumed into models of how health IT adoption would increase efficiency, write RAND analysts Arthur Kellermann, MD, and Spencer Jones, a bioinformaticist. Comparing the consumer experience in health IT to other industries, Kellerman and Jones explain that for patients and clinicians, modern EHR software at times “functions less as ‘ATM cards,’ allowing a patient or provider to access needed health information anywhere at any time, than as ‘frequent flier cards’ intended to enforce brand loyalty to a particular health care system.”...